Results of combined left ventricular aneurysmectomy and coronary artery bypass: 1974 to 1980.

Left ventricular aneurysm repair with coronary artery bypass grafting was performed in 104 patients from 1974 through 1980. The patients' mean age was 57 years. Preoperatively, 48 percent were in New York Heart Association functional class III and 31 percent were in class IV. Stenosis of multiple vessels was common, as was a reduced ejection fraction (24 percent had an ejection fraction of less than 30 percent). Thrombus was present in 47 percent of resected aneurysms. Bypass grafting was performed to all graftable coronary vessels. Actuarial survival rates were 89.3 percent at 1 year, 86.1 percent at 2 years, and 74.5 percent (standard error 5.1 percent) at 5 years. One year postoperatively, 86 percent of the surviving patients were in class I, 11 percent class II, 1 percent class III, and 2 percent class IV. Patients who presented with angina alone had an excellent result, with 95 percent hospital survival. Congestive heart failure was an ominous finding, since four of five patients who developed it before discharge died in the hospital, and 38 percent of those who went into heart failure after discharge have died.