Elective operations for post-infarction left ventricular aneurysms.

The regional structure of the National Health Service enables specialist regional units to monitor both the amount and the quality of the work they do in relation to the population they serve and the facilities at their disposal. This applies particularly to the specialist unit holding a monopoly position in its region such as the cardiac surgical service in Wessex. This paper reports a review of 1000 consecutive open-heart procedures carried out in the Wessex regional unit at Southampton from September 1972 to April 1976. Wessex Region and facilities The Wessex Region covers central southern England and includes the counties of Hampshire, Dorset, and Wiltshire and the Isle of Wight. The population is 2 7 million and the annual birth rate is 12 7 births per 1000 population (1974). The cardiothoracic unit has 20 beds allocated for cardiac surgical patients, including a paediatric unit separate from the adult beds; four intensive care beds; and two operating theatres providing 10 cardiac operating sessions a week. The great majority of the cardiac work is done in one operating theatre during eight of the available

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Left ventricular aneurysm. The Wessex experience.

Keenan¹,

Monro²,

Ross³

et al. 1985

Heart

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(83 anterolateral, two lateral, 15 inferior) had occurred a mean of 14 (SD 18) months before operation, and 11 patients had had multiple previous infarcts. The principal indications for operation were left ventricular failure alone (58), angina alone (23), and the combination of dyspnoea and angina (17). Ventricular arrhythmias were present in 10 patients, although this was the principal indication for operation in only one. Recurrent systemic embolism was present in six, but was the sole indication for operation in only one. Sixty six of those with dyspnoea were in New York Heart Association class IV with 43 of these receiving maximal medical treatment (at least 250 mg frusemide daily, digoxin, and afterload reduction).All were investigated by left ventriculography in two planes and coronary angiography. Left ventricular end diastolic pressure was routinely measured and had a mean of 19-5 (SD 9.6) mm Hg. At The results of coronary angiography were available for analysis in 96 patients (Fig. 1). Eighty four had 269

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Elective operations for post-infarction left ventricular aneurysms.

Cited by 3 publications

References 23 publications

Aneurysmektomie

Aneurysmektomie

Cardiac surgery in Wessex: review of 1000 consecutive open-heart procedures.

Left ventricular aneurysm. The Wessex experience.

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