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Of 76 patients with postinfarction left ventricular aneurysm (LVA), aortocoronary bypasses were carried out in 34, patch plasty of the left ventricular free wall in 14, closure of the ventricular septal defect in 9 and ventriculoplasty in 5. Operative mortality rate was 5.2% (3/59). Five of 5 patients with residual LVA underwent reoperation because of a recurrence of the postinfarction bulge of the free wall. There were no recurrences of the postinfarction bulge in the aortocoronary bypass or the patch plasty group. Of the 14 patients with the postinfarction LVA, 11 (79%) improved in NYHA class after surgery, the mean percentage of the increase in ejection fraction being 24.1% (p less than 0.01), and 6 of the 7 patients without residual LVA improved in NYHA class. There were no perioperative complications in the patch plasty group except for cardiac arrhythmias.
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