Endoventriculoplasty using autologous endocardium for anterior left ventricular aneurysms

Background: There is currently consensus that endoventriculoplasty is the treatment of choice for an anterior left ventricular aneurysm. We describe here a new technique of endoventriculoplasty using autologous endocardium for left ventricular anterior aneurysm. Method: From 1990 until 2003, 49 patients underwent endoventriculoplasty using autologous pericardium at the Thoraxcenter of the University Hospital of Groningen in the Netherlands (28 patients) and at the Department of Cardio Thoracic Surgery of the University Hospital of Pisa in Italy (21 patients). Mean logistic EuroSCORE and mean ejection fraction were 15.7 +/- 6.7 and 31 +/- 9%, respectively. Results: Overall 30-day mortality was 4.1%. Causes of in-hospital mortality were low output syndrome (I patient) and ventricular fibrillation (1 patient). Postoperative complications were myocardial infarct (4.1%), low output syndrome (6.1%), renal failure (4.1%), neurological events (2.0%), atrial fibrillation (14.3%), ventricular fibrillation or tachycardia (6.1%), ARDS (4.1%), re-operation for bleeding (4.1%), and major wound infection (2.0%). Conclusion: Our analysis shows that endoventriculoplasty with autologous endocardium is a safe procedure and improves the outcome in high-risk patients with ventricular aneurysm.