Cardiac CT for Assessment of Myocardial Geometry before and after Surgical Repair of Apical Left Ventricular Aneurysm

Abstract

Aim: To assess left ventricular volumetric, morphologic, and functional changes after surgical restoration of anteroapical left ventricular aneurysm using MSCT.

Material and Methods: 35 patients with anteroapical LV aneurysm were assessed by MSCT before and shortly after surgery mesuaring sphericity index (SI; short-to-long axis ratio), apical conicity index (ACI; apical-to-short axis length ratio), apical conicity ratio (ACR; ratio of apical area to apical triangle) as well as LV function, thickness und thickening of systolic and diastolic LV basal myocardium and LV end-systolic and end diastolic volumes. Results: After surgical repair there were statistically significant reductions of absolute and indexed LV volumes (p < 0.05): LV-EDVI mean -33,7 ± 17 %, LV-ESVI mean -39.05 ± 20.0 %. LV-EF increased significantly by 28.88 % (p = 0,00). Significant reduction of wall thickness during end-systole (p = 0.009) and end-diastole (p = 0.034) and significant increase of diastolic SI (p < 0.05) were observed as well as a significant decline in systolic (p = 0.007) and diastolic (p = 0.005) ACI and a significant increase in systolic (p = 0.026) and diastolic (p = 0.038) ACR.

Conclusions: After surgical LV restoration, MSCT demonstrates significant reduction of LV volume and a reduction of wall thickness leading to improved LV function and a more efficient morphologic LV shape. Postoperative SI increases, probably due to shortened LV long axis. ACI decline and ACR increase indicate a return toward a more ellipsoid shape after LV repair.