Single-centre experience with perioperative use of hypothermic fibrillatory arrest without aortic occlusion in left ventricular aneurysm resection concomitant with on-pump coronary artery bypass grafting

Abstract

Background Hypothermic fibrillatory arrest (HFA) without aortic occlusion has been long used for preserving myocardium in cardiac surgery. This study was to evaluate whether HFA can affect clinical outcomes in patients having left ventricular aneurysm (LVA) resection concomitant with on-pump coronary artery bypass grafting (OPCABG). Methods From March, 2005, through November, 2012, 11 men and 1 woman (mean age 53 ± 7 years) were subjected to LVA resection and subsequent OPCABG during HFA. Primary indications for operation were angina pectoris (unstable angina in 7), congestive heart failure in 4, ventricular arrhythmias in 3. Mean New York Heart Association Class was 2.8. Mean left ventricular ejection fraction (LVEF) was 0.34 ± 0.05. Results Five patients had linear closure and seven had left ventricular reconstruction. Coronary surgery was performed in all patients with average 2.3 grafts/patient. Mean duration of cardiopulmonary bypass was 97 ± 38 mins and mean ventilation time was 21 ± 15 hrs. Mean postoperative LVEF was 0.41 ± 0.08. The overall hospital mortality rate was zero. At late follow-up, no patient died from 8 to 24 months. Conclusion HFA is a safe and effective technique in the procedure of LVA resection concomitant with OPCABG. Low hospital mortality, improved cardiac function status and survival are potential advantages.