[Longterm prognosis of 27 patients with left ventricular aneurysm and conservative treatment (author's transl)].

The results of a follow-up study (mean 42 months after infarction) of 27 patients with conservatively treated left ventricular aneurysms showed: 1. 3/27 patients died of sudden death. Only one of these three could be predicted (ventricular fibrillation during exercise). 2. 3/24 remaining patients developed congestive heart failure. This could be predicted in one patient because of global hypocinesia of the left ventricle. 3. The exercise tolerance (Swan-Ganz) of the remaining 21 patients decreased from approximately 100 to 70 watts. Thus, all patients were able to lead an almost normal live. 4. Therefore conservative treatment of left ventricular aneurysms in most cases is the method of choice, since high surgical mortality, financial burdens of the society and man power has also to be considered. 5. The development of complications which would lead to aneurysmectomy (sudden death, life threatening arrhythmias, embolisation, congestive heart failure) cannot be foreseen from history, non-invasive and invasive data. 6. The close "patient to physician-contact" (risk-factors, medication) may have influenced the relatively good long-term prognosis of this group.