Ventricular aneurysm: Cross-sectional echocardiographic approach

Current angiographic indexes of ventricular function have proved inadequate for prognostication in patients with ventricular aneurysm. Crosssectional echocardiography can visualize residual myocardium in all four walls of the left ventrlcle. A new echocardiographic technique of calculating residual myocardium is presented. The echocardiographic technique yielded identical information to that of contrast angiography (r = 0.97). An index of residual myocardium was generaled from the cross-sectlonal echocardiogram that correlated with the clinical state of the patients. In patients treated medically it predicted those patients likely to die within 6 months (p < 0.005). Preliminary observations in patients having aneurysmectomy revealed that there were good surgical results in those with an index of residual myocardium of 0.42 or greater, but more patients are necessary to establish the lower limit of a surgically acceptable level of residual myocardium.