Aneurismectomia de ventrículo esquerdo com o coração batendo ininterruptamente: resultados imediatos

OBJECTIVE: Operative mortality after left ventricular aneurysmectomy is close to 15%. Specifically for this procedure, forms of myocardial protection have been little discussed. The purpose of this study was to evaluate immediate results of left anterior ventricular aneurysmectomy using the beating heart approach. METHOD: We performed a retrospective analysis of 34 patients who underwent a left anterior ventricular aneurysmectomy, both with and without revascularization, from January 1997 to May 2005. The series consisted of 20 males and 14 females with a mean age of 52 years-old (range: 28 to 76). All of them were operated on cardiopulmonary bypass with normothermia, aortic cross-clamping was used but the open-beating heart was. We evaluated the perioperative mortality, thromboembolic events, duration of cardiopulmonary bypass, the length of stay in intensive care unit and the use of invasive ventilatory assistance. RESULTS: There were no perioperative mortalities or thromboembolic events. The cardiopulmonary bypass time was 85 minutes (range: 25-150 minutes). Invasive ventilatory assistance was used on average for 18 hours (range: 8-96 hours) and the mean stay in intensive unit care was 3.1 days (range: 2-14 days). CONCLUSION: The beating heart approach constitutes a safe and efficient cardioprotective method for anterior left ventricular aneurysmectomy procedures.