- Email: [email protected]
OP-228: PREVALENCE AND PREDICTORS OF RENAL ARTERY STENOSIS IN HYPERTENSIVE PATIENTS UNDERGOING ELECTIVE CORONARY ANGIOGRAPHY
Oral Presentations / International Journal of Cardiology 147S2 (2011) S37–S98
dipper subgroup of normotensive cases (QTapex/R-R = 0.17±0.02 vs. 0.13±0.02, p = 0.001; QTend/R-R = 0.16±0.02 vs. 0.13±0.02, p = 0.001). QTapex/R-R and QTend/R-R slopes were higher in non-dipper subgroup of hypertensive cases with respect to the dipper subgroup of hypertensive cases (QTapex/R-R = 0.19±0.02 vs. 0.13±0.02, p = 0.001; QTend/R-R = 0.18±0.02 vs. 0.15±0.02, p = 0.001). There was a higher negative correlation between percentage of nocturnal fall in BP and QTapex/R-R (r=-0.638, p = 0.001). There was also a moderate negative correlation between percentage of nocturnal fall in BP and QTend/R-R (r=-0.504, p = 0.001). Conclusions: When the prognostic significance of these autonomic indices is considered, hypertensives and normotensives with a non-dipping pattern should be followed closely for adverse cardiovascular outcomes
Figure 1. Relationship between percentage of decline in night-time arterial blood pressure and QTapex/R-R. r, refers to correlation coefficient. OP-226 GNB3 C825T POLYMORPHISM ASSOCIATES WITH PLASMA ELECTROLYTE BALANCE AND SUSCEPTIBILITY TO HYPERTENSION A. Nejatizadeh1 , E. Arif2 , O. Assar1 , M.Q. Pasha2 . 1 Research Center for Molecular Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; 2 Institute of Genomics and Integrative Biology, Delhi, India Objective: The role of G protein activation in cardiovascular disorders is well known. The GNB3 C825T polymorphism of the gene encoding the G-protein b3 subunit (GNB3) is associated with increased intracellular signal transduction. We aimed to investigate the role of the variant in susceptibility to hypertension and association with plasma sodium and potassium concentrations. Methods: Consecutive subjects consisting 345 healthy controls and 455 patients with essential hypertension were enrolled. Plasma renin activity and aldosterone concentration were measured. The variant was typed by SNaPshot, analyzed on ABI Prism 3100 Genetic Analyzer and ABI Prism GeneScan. Results: The TT genotype was over-represented in the patients (LRTc2 = 16.2, P < 0.001) and T allele as well (LRTc2 = 25.9, P < 0.0001). Multiple-logistic regression analysis disclosed that the risk of hypertension was significantly greater for TT genotype (P < 0.0001, OR = 6.1, Wald’s 95% CI = 2.9–12.7). One-way ANOVA revealed that hypertensive T-allele carriers (CT+TT) compared to non-carriers (CC) had a greater BMI, mean arterial pressure (MAP) and PAC (P = 0.01, P = 0.01, P < 0.0001, respectively); while the
S91
patients with 825TT risk genotype showed higher plasma sodium, serum creatinine, urea and lower potassium (P < 0.0001, each). Conclusions: Our results strongly highlight the role of GNB3 C825T polymorphism leading to an increased activity of G-protein, enhanced the Na/H exchanger and subsequently associates with higher plasma sodium, lower potassium levels, high BMI and susceptibility to hypertension. OP-227 THE EFFECT OF NEBIVOLOL TREATMENT ON ENDOTHELIAL AND ERECTILE FUNCTIONS IN HYPERTENSIVE MEN B. Ozben1 , U. Kefeli1 , A. Cincin1 , O. Baykan1 , O. Ozgur2 , C. Akbal2 , Y. Basaran1 , O. Yesildag1 . 1 Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey; 2 Department of Urology, Marmara University Faculty of Medicine, Istanbul, Turkey Objective: Impaired nitric oxide (NO) bioactivity is a major pathogenic mechanism of both endothelial and erectile dysfunction. Nebivolol is a third-generation beta-blocker that causes vasodilatation via interaction with the endothelial L-arginine/nitric oxide (NO) pathway. The aim of this study is to evaluate the effects of nebivolol on endothelial and erectile functions in hypertensive male patients. Methods: Forty hypertensive patients (mean age: 53.5±10.1 years) who were given nebivolol 5 mg/day and had complaints of erectile dysfunction were consecutively recruited into the study. Endothelial function was assessed by brachial arterial flowmediated dilation (FMD). International Index of Erectile Functions questionaire was used to assess erectile function. Endothelial and erectile functions of the patients were evaluated before the nebivolol therapy and at the first and third month of the therapy. Results: The response of blood pressure, heart rate, endothelial and erectile functions to nebivolol therapy are presented in Table 1. The FMD values and erectile function scores at the third month of therapy were both significantly higher than the basal values. Nebivolol decreased the number of patients with FMD values <10% (26 vs 14, p = 0.012) and the number of patients with moderate to severe erectile dysfunction (scores ≤21) (38 vs 26, p < 0.001) at the third month of therapy. There was not any significant correlation between FMD measures and erectile function scores. Conclusions: Nebivolol improved both the endothelial and erectile dysfunction in hypertensive male patients. It might be preferred in hypertensive patients with complaints of erectile dysfunction. Table 1. The response of blood pressure, heart rate, endothelial and erectile functions to nebivolol therapy. Systolic BP (mmHg) Diastolic BP (mmHg) Heart rate (/min) Baseline velocity (cm/s) Baseline diameter (mm) Post-ischemic flow velocity (cm/s) FMD absolute (mm) FMD percentage (%) Erectile function scores
Baseline
1. Month
3. Month
p
156.5±18.9 83.1±10.5 76±10 48.25±13.36 3.98±0.52 106.49±25.23 0.31±0.14 7.98±3.76 11.2±7.2
143.8±17.7 80.3±10.9 72±10 46.75±11.28 3.88±0.52 106.67±28.83 0.38±0.16 9.94±4.44 13.6±7.3
132.4±13.5 80.1±9.2 70±8 46.95±12.62 3.94±0.55 115.83±26.53 0.46±0.16 12.14±4.75 16.4±8.5
<0.001 0.061 <0.001 0.402 0.052 0.001 <0.001 <0.001 <0.001
BP; blood pressure, FMD; flow mediated dilation
OP-228 PREVALENCE AND PREDICTORS OF RENAL ARTERY STENOSIS IN HYPERTENSIVE PATIENTS UNDERGOING ELECTIVE CORONARY ANGIOGRAPHY G. Kabakci, U. Canpolat, H. Yorgun, G. Fatihoglu, U. Karakulak, H. Sunman, U. Yalcin, L. Sahiner, E.B. Kaya, K. Aytemir, L. Tokgozoglu, A. Oto. Department of Cardiology, Hacettepe University, Ankara, Turkey Objective: Atherosclerotic process is the most common cause of renal artery disease, accounting for 90% of renal artery stenosis (RAS). Moreover, RAS has important effects on the prognosis of cardiovascular disease. RAS remains underdiagnosed because of nonspecific clinical signs, including in patients with coronary artery
S92
Oral Presentations / International Journal of Cardiology 147S2 (2011) S37–S98
disease (CAD). In this study, we aimed to define its prevalence and explain potential predictors of angiographic RAS in a cohort of hypertensive patients underwent elective coronary procedures. Methods: We included 246 consecutive hypertensive patients admitted to cardiology department for evaluation of coronary artery disease and underwent catheterization laboratory for elective diagnostic or interventional coronary procedures during the period from July 2004 to November 2010. All patients underwent selective renal arteriography in the same procedure. Other causes of secondary hypertension (other than RAS) were excluded by appropriate clinical and laboratory testing. Patients were considered to have significant RAS if they had at least a 60% luminal obstruction of one or both renal arteries. Patients were classified into normal renal arteries, insignificant RAS, and significant RAS. Results: The mean age was 62.5±10.1 years, and 125 (50.8%) were males. 55 (22.4%) patients had previously diagnosed CAD. Mean hypertension duration was 10.7±8.3 years. 18 (7.3%) patients underwent percutaneous coronary intervention at the same procedure. Significant renal artery stenosis was found in 12 (4.9%) patients and all of them underwent renal artery stenting successfully. It correlated significantly with hypertension duration (P = 0.001), history of stroke (P = 0.022), history of angioplasty to coronary vessels (P = 0.001), and extent of coronary disease (P = 0.001). Multivariate regression analysis showed multivessel coronary artery disease as independent predictor of renal artery stenosis, with odds ratios of 7.4. Conclusions: RAS is not uncommon among hypertensive patients undergoing elective coronary angiography for known or suspected CAD. Screening for RAS by invasive renal angiography might be performed at the time of catheterization in hypertensive patients with multivessel coronary disease. Saturday, 26 March 2011
13:30–15:00
Mitral and Aortic Valve Surgery: What is New? OP-231 REPAIR OF RHEUMATIC MITRAL VALVE DISEASE USING ARTIFICIAL CHORDAE IMPLANTATION H.H. Al Masri. Department of Cardiac Surgery, IJN, KL, Malaysia, France Objective: Repairing of degenerative mitral valve disease implantation of artificial chordae has been extensively used as a preferred choice. However, the use of artificial chordae in rheumatic valve repair is not established. In rheumatic valve disease, often the native chordae is diseased, shortened and not suitable for chordal procedures like transfer or shortening. Artificial chordae with expanded polytetrafluoroethylene (ePTEE) offers a suitable alternative and favorable early clinical results. In this study we evaluate our early and mid term results of artificial chordae implantation in rheumatic mitral valve disease. Methods: From 2000 through 2009, prospectively collected data of patients who underwent mitral valve repair from a single institution were reviewed. 753 patients with various etiology of mitral valve disease had mitral valve repair. 125 out of 376 patients with rheumatic mitral valve disease who had artifical chordal implantation as part of their repair procedure formed the study group. Results: The mean age of the patients was 26.44+17.08 years (67.3% females). The sites of artificial chordate implantation were anterior leaflet in 102 patients, both leaflets in 13 patients, and posterior leaflet in 10 patients. The follow-up was complete in all patients by clinical and echocardiographic examination in a range of follow up between 1–97 months. There was one late death. No early mortality was found. Except two patients who required reoperation for failure. During the latest follow up, residual MR was absent in 34 (38%) patients, trivial in 13 (15%) patients, mild in 27 (32%)
patients, moderate in 10 (9%) patients and severe in 6 (5%) patients. Postoperatively 5 year term estimated patient overall survival was 98.6% and freedom from reoperation was 98.6%. Conclusions: MVR with artificial chordae provided satisfactory valve function, mitral valve repair with artificial chordate implantation in patients with rheumatic disease demonstrated favorable early and mid-term outcome. The procedure is therefore safe and effective, with potential for patients’ growth. Saturday, 26 March 2011
15:30–17:00
New Perspectives in Coronary Surgery OP-241 WHAT’S THE ROLE OF VENTRICULAR ENDOCARDIAL RECONSTRUCTION SURGERY IN 2011? A SINGLE CENTRE 7 YEAR EXPERIENCE R. Attia, H. Flemming, J. Chambers, F. Shabbo. Guy’s and St. Thomas Hospital, London, United Kingdom Objective: Surgical ventricular restoration in patients with coronary artery disease, post infarction left ventricular aneurysm or ischemic dilated cardiomyopathy with or without ventricular tachycardia is a viable treatment option. Conflicting data exist in published literature as to the utility of this technique. We aimed to evaluate the 7-year clinical experience of this procedure in our institution. Methods: From January 2003 to 2010, surgical ventricular restoration was performed in 86 patients (M:F 2.3:1), mean age 64.5 (44–84) years. All patients presented with angina, heart failure and/or ventricular tachycardia. Post-infarction left ventricular aneurysm was present in all patients and ischemic dilated cardiomyopathy with a large akinetic left ventricle in 10/86 (11.6%). The preoperative left ventricular ejection fraction was 33.1±10%. Multi-vessel disease was present in 80/86 (93%) patients. Mitral regurgitation more than grade 2 was found in 10/86 (11.6%). The mean Logistic Euroscore was 13.8±2.9%. Results: All patients underwent endoventricular or circular patch repair. 94% had concomitant coronary revascularisation, median of 2 grafts and 5% had mitral valve repair. Intra-aortic balloon pump was placed pre-operatively in 16/86 (18.6%) while 14/86 (16.2%) needed inotropic support for more than 24h. Postoperative stroke occurred in 1 patient. In-hospital mortality was 4/86 (4.6%). All cause cardiovascular mortality at five years was 7/86 (8.1%). Mean follow-up in operative survivors was 4.4±2.8years. Actuarial survival at 1, 2 and 5 years was 90.6%, 87.9% and 79.1%. Echocardiographic data demonstrated a 1-year reduction in the mean LVED and LA dimensions. Ejection fraction improved over first post-operative year from 33.1±10 to 45±15%. Conclusions: Left ventricular reconstruction surgery is a reproducible surgical option for treatment of postinfarction left ventricular aneurysm. Early and long-term results are good in terms of survival and better when compared to ventricular resynchronisation therapy and medical management.
dipper subgroup of normotensive cases (QTapex/R-R = 0.17±0.02 vs. 0.13±0.02, p = 0.001; QTend/R-R = 0.16±0.02 vs. 0.13±0.02, p = 0.001). QTapex/R-R and QTend/R-R slopes were higher in non-dipper subgroup of hypertensive cases with respect to the dipper subgroup of hypertensive cases (QTapex/R-R = 0.19±0.02 vs. 0.13±0.02, p = 0.001; QTend/R-R = 0.18±0.02 vs. 0.15±0.02, p = 0.001). There was a higher negative correlation between percentage of nocturnal fall in BP and QTapex/R-R (r=-0.638, p = 0.001). There was also a moderate negative correlation between percentage of nocturnal fall in BP and QTend/R-R (r=-0.504, p = 0.001). Conclusions: When the prognostic significance of these autonomic indices is considered, hypertensives and normotensives with a non-dipping pattern should be followed closely for adverse cardiovascular outcomes
Figure 1. Relationship between percentage of decline in night-time arterial blood pressure and QTapex/R-R. r, refers to correlation coefficient. OP-226 GNB3 C825T POLYMORPHISM ASSOCIATES WITH PLASMA ELECTROLYTE BALANCE AND SUSCEPTIBILITY TO HYPERTENSION A. Nejatizadeh1 , E. Arif2 , O. Assar1 , M.Q. Pasha2 . 1 Research Center for Molecular Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; 2 Institute of Genomics and Integrative Biology, Delhi, India Objective: The role of G protein activation in cardiovascular disorders is well known. The GNB3 C825T polymorphism of the gene encoding the G-protein b3 subunit (GNB3) is associated with increased intracellular signal transduction. We aimed to investigate the role of the variant in susceptibility to hypertension and association with plasma sodium and potassium concentrations. Methods: Consecutive subjects consisting 345 healthy controls and 455 patients with essential hypertension were enrolled. Plasma renin activity and aldosterone concentration were measured. The variant was typed by SNaPshot, analyzed on ABI Prism 3100 Genetic Analyzer and ABI Prism GeneScan. Results: The TT genotype was over-represented in the patients (LRTc2 = 16.2, P < 0.001) and T allele as well (LRTc2 = 25.9, P < 0.0001). Multiple-logistic regression analysis disclosed that the risk of hypertension was significantly greater for TT genotype (P < 0.0001, OR = 6.1, Wald’s 95% CI = 2.9–12.7). One-way ANOVA revealed that hypertensive T-allele carriers (CT+TT) compared to non-carriers (CC) had a greater BMI, mean arterial pressure (MAP) and PAC (P = 0.01, P = 0.01, P < 0.0001, respectively); while the
S91
patients with 825TT risk genotype showed higher plasma sodium, serum creatinine, urea and lower potassium (P < 0.0001, each). Conclusions: Our results strongly highlight the role of GNB3 C825T polymorphism leading to an increased activity of G-protein, enhanced the Na/H exchanger and subsequently associates with higher plasma sodium, lower potassium levels, high BMI and susceptibility to hypertension. OP-227 THE EFFECT OF NEBIVOLOL TREATMENT ON ENDOTHELIAL AND ERECTILE FUNCTIONS IN HYPERTENSIVE MEN B. Ozben1 , U. Kefeli1 , A. Cincin1 , O. Baykan1 , O. Ozgur2 , C. Akbal2 , Y. Basaran1 , O. Yesildag1 . 1 Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey; 2 Department of Urology, Marmara University Faculty of Medicine, Istanbul, Turkey Objective: Impaired nitric oxide (NO) bioactivity is a major pathogenic mechanism of both endothelial and erectile dysfunction. Nebivolol is a third-generation beta-blocker that causes vasodilatation via interaction with the endothelial L-arginine/nitric oxide (NO) pathway. The aim of this study is to evaluate the effects of nebivolol on endothelial and erectile functions in hypertensive male patients. Methods: Forty hypertensive patients (mean age: 53.5±10.1 years) who were given nebivolol 5 mg/day and had complaints of erectile dysfunction were consecutively recruited into the study. Endothelial function was assessed by brachial arterial flowmediated dilation (FMD). International Index of Erectile Functions questionaire was used to assess erectile function. Endothelial and erectile functions of the patients were evaluated before the nebivolol therapy and at the first and third month of the therapy. Results: The response of blood pressure, heart rate, endothelial and erectile functions to nebivolol therapy are presented in Table 1. The FMD values and erectile function scores at the third month of therapy were both significantly higher than the basal values. Nebivolol decreased the number of patients with FMD values <10% (26 vs 14, p = 0.012) and the number of patients with moderate to severe erectile dysfunction (scores ≤21) (38 vs 26, p < 0.001) at the third month of therapy. There was not any significant correlation between FMD measures and erectile function scores. Conclusions: Nebivolol improved both the endothelial and erectile dysfunction in hypertensive male patients. It might be preferred in hypertensive patients with complaints of erectile dysfunction. Table 1. The response of blood pressure, heart rate, endothelial and erectile functions to nebivolol therapy. Systolic BP (mmHg) Diastolic BP (mmHg) Heart rate (/min) Baseline velocity (cm/s) Baseline diameter (mm) Post-ischemic flow velocity (cm/s) FMD absolute (mm) FMD percentage (%) Erectile function scores
Baseline
1. Month
3. Month
p
156.5±18.9 83.1±10.5 76±10 48.25±13.36 3.98±0.52 106.49±25.23 0.31±0.14 7.98±3.76 11.2±7.2
143.8±17.7 80.3±10.9 72±10 46.75±11.28 3.88±0.52 106.67±28.83 0.38±0.16 9.94±4.44 13.6±7.3
132.4±13.5 80.1±9.2 70±8 46.95±12.62 3.94±0.55 115.83±26.53 0.46±0.16 12.14±4.75 16.4±8.5
<0.001 0.061 <0.001 0.402 0.052 0.001 <0.001 <0.001 <0.001
BP; blood pressure, FMD; flow mediated dilation
OP-228 PREVALENCE AND PREDICTORS OF RENAL ARTERY STENOSIS IN HYPERTENSIVE PATIENTS UNDERGOING ELECTIVE CORONARY ANGIOGRAPHY G. Kabakci, U. Canpolat, H. Yorgun, G. Fatihoglu, U. Karakulak, H. Sunman, U. Yalcin, L. Sahiner, E.B. Kaya, K. Aytemir, L. Tokgozoglu, A. Oto. Department of Cardiology, Hacettepe University, Ankara, Turkey Objective: Atherosclerotic process is the most common cause of renal artery disease, accounting for 90% of renal artery stenosis (RAS). Moreover, RAS has important effects on the prognosis of cardiovascular disease. RAS remains underdiagnosed because of nonspecific clinical signs, including in patients with coronary artery
S92
Oral Presentations / International Journal of Cardiology 147S2 (2011) S37–S98
disease (CAD). In this study, we aimed to define its prevalence and explain potential predictors of angiographic RAS in a cohort of hypertensive patients underwent elective coronary procedures. Methods: We included 246 consecutive hypertensive patients admitted to cardiology department for evaluation of coronary artery disease and underwent catheterization laboratory for elective diagnostic or interventional coronary procedures during the period from July 2004 to November 2010. All patients underwent selective renal arteriography in the same procedure. Other causes of secondary hypertension (other than RAS) were excluded by appropriate clinical and laboratory testing. Patients were considered to have significant RAS if they had at least a 60% luminal obstruction of one or both renal arteries. Patients were classified into normal renal arteries, insignificant RAS, and significant RAS. Results: The mean age was 62.5±10.1 years, and 125 (50.8%) were males. 55 (22.4%) patients had previously diagnosed CAD. Mean hypertension duration was 10.7±8.3 years. 18 (7.3%) patients underwent percutaneous coronary intervention at the same procedure. Significant renal artery stenosis was found in 12 (4.9%) patients and all of them underwent renal artery stenting successfully. It correlated significantly with hypertension duration (P = 0.001), history of stroke (P = 0.022), history of angioplasty to coronary vessels (P = 0.001), and extent of coronary disease (P = 0.001). Multivariate regression analysis showed multivessel coronary artery disease as independent predictor of renal artery stenosis, with odds ratios of 7.4. Conclusions: RAS is not uncommon among hypertensive patients undergoing elective coronary angiography for known or suspected CAD. Screening for RAS by invasive renal angiography might be performed at the time of catheterization in hypertensive patients with multivessel coronary disease. Saturday, 26 March 2011
13:30–15:00
Mitral and Aortic Valve Surgery: What is New? OP-231 REPAIR OF RHEUMATIC MITRAL VALVE DISEASE USING ARTIFICIAL CHORDAE IMPLANTATION H.H. Al Masri. Department of Cardiac Surgery, IJN, KL, Malaysia, France Objective: Repairing of degenerative mitral valve disease implantation of artificial chordae has been extensively used as a preferred choice. However, the use of artificial chordae in rheumatic valve repair is not established. In rheumatic valve disease, often the native chordae is diseased, shortened and not suitable for chordal procedures like transfer or shortening. Artificial chordae with expanded polytetrafluoroethylene (ePTEE) offers a suitable alternative and favorable early clinical results. In this study we evaluate our early and mid term results of artificial chordae implantation in rheumatic mitral valve disease. Methods: From 2000 through 2009, prospectively collected data of patients who underwent mitral valve repair from a single institution were reviewed. 753 patients with various etiology of mitral valve disease had mitral valve repair. 125 out of 376 patients with rheumatic mitral valve disease who had artifical chordal implantation as part of their repair procedure formed the study group. Results: The mean age of the patients was 26.44+17.08 years (67.3% females). The sites of artificial chordate implantation were anterior leaflet in 102 patients, both leaflets in 13 patients, and posterior leaflet in 10 patients. The follow-up was complete in all patients by clinical and echocardiographic examination in a range of follow up between 1–97 months. There was one late death. No early mortality was found. Except two patients who required reoperation for failure. During the latest follow up, residual MR was absent in 34 (38%) patients, trivial in 13 (15%) patients, mild in 27 (32%)
patients, moderate in 10 (9%) patients and severe in 6 (5%) patients. Postoperatively 5 year term estimated patient overall survival was 98.6% and freedom from reoperation was 98.6%. Conclusions: MVR with artificial chordae provided satisfactory valve function, mitral valve repair with artificial chordate implantation in patients with rheumatic disease demonstrated favorable early and mid-term outcome. The procedure is therefore safe and effective, with potential for patients’ growth. Saturday, 26 March 2011
15:30–17:00
New Perspectives in Coronary Surgery OP-241 WHAT’S THE ROLE OF VENTRICULAR ENDOCARDIAL RECONSTRUCTION SURGERY IN 2011? A SINGLE CENTRE 7 YEAR EXPERIENCE R. Attia, H. Flemming, J. Chambers, F. Shabbo. Guy’s and St. Thomas Hospital, London, United Kingdom Objective: Surgical ventricular restoration in patients with coronary artery disease, post infarction left ventricular aneurysm or ischemic dilated cardiomyopathy with or without ventricular tachycardia is a viable treatment option. Conflicting data exist in published literature as to the utility of this technique. We aimed to evaluate the 7-year clinical experience of this procedure in our institution. Methods: From January 2003 to 2010, surgical ventricular restoration was performed in 86 patients (M:F 2.3:1), mean age 64.5 (44–84) years. All patients presented with angina, heart failure and/or ventricular tachycardia. Post-infarction left ventricular aneurysm was present in all patients and ischemic dilated cardiomyopathy with a large akinetic left ventricle in 10/86 (11.6%). The preoperative left ventricular ejection fraction was 33.1±10%. Multi-vessel disease was present in 80/86 (93%) patients. Mitral regurgitation more than grade 2 was found in 10/86 (11.6%). The mean Logistic Euroscore was 13.8±2.9%. Results: All patients underwent endoventricular or circular patch repair. 94% had concomitant coronary revascularisation, median of 2 grafts and 5% had mitral valve repair. Intra-aortic balloon pump was placed pre-operatively in 16/86 (18.6%) while 14/86 (16.2%) needed inotropic support for more than 24h. Postoperative stroke occurred in 1 patient. In-hospital mortality was 4/86 (4.6%). All cause cardiovascular mortality at five years was 7/86 (8.1%). Mean follow-up in operative survivors was 4.4±2.8years. Actuarial survival at 1, 2 and 5 years was 90.6%, 87.9% and 79.1%. Echocardiographic data demonstrated a 1-year reduction in the mean LVED and LA dimensions. Ejection fraction improved over first post-operative year from 33.1±10 to 45±15%. Conclusions: Left ventricular reconstruction surgery is a reproducible surgical option for treatment of postinfarction left ventricular aneurysm. Early and long-term results are good in terms of survival and better when compared to ventricular resynchronisation therapy and medical management.