Relation of aneurysmectomy in patients with advanced left ventricular remodeling to postoperative left ventricular filling pressure, redilatation with ischemic mitral regurgitation

Left ventricular (LV) volume, mitral E deceleration time, and mitral regurgitation (MR) fraction were measured by echocardiography in 14 patients with surgical LV aneurysmectomy. Late MR developed 3 to 6 months after surgery in 5 of the 14 patients (36%). Compared with patients without late MR, those with late MR had a significantly greater preoperative LV end-diastolic volume index (LVEDVI) (134 ± 21 vs 93 ± 19 ml/m2, p <0.01), surgical reduction in LVEDVI (−51 ± 14 vs −20 ± 16 ml/m2, p <0.01), early postoperative LV diastolic dysfunction with shortened mitral E deceleration time (106 ± 23 vs 141 ± 24 ms, p <0.01), and a late postoperative reincrease in LVEDVI (+28 ± 4 vs +3 ± 8 ml/m2, p <0.01), suggesting that surgical LV aneurysmectomy in patients with advanced preoperative LV remodeling may result in postoperative LV diastolic dysfunction, promoting later LV redilation with ischemic MR.