Surgical treatment of left ventricular aneurysm and ischemic mitral incompetence.

Chronic left ventricular aneurysm and ischemic mitral valve incompetence have been treated during the last 2 years with more physiologic techniques. Left ventricular reconstruction with the endoaneurysmorrhaphy technique was carried out in 20 patients. Sixteen patients had additional procedures. Early mortality was 5% and functional results are encouraging with 18 patients in NYHA class I of II. Mitral valve repair was carried out in combination with myocardial revascularization in 15 patients. All patients had a Carpentier Edwards annuloplasty ring implanted. Nine patients needed additional reconstructive procedures. There were no early or late deaths neither reoperations. Late functional results are good with all patients in NYHA, class I or II. Three patients present a mild mitral regurgitation on echo. This physiologic approach to restore volume, size and shape of the left ventricle and the mitral valve can be combined with CABG without additional operative risk and excellent results up to 2 years.