European Journal of Cardio-Thoracic Surgery, Vol 12, 642-647, Copyright © 1997 by European Association for Cardio-thoracic Surgery
The effects of simulated akinetic and dyskinetic aneurysms on left ventricular systolic function: clinical implications
PH Hadland, W Kottmann, M Jette, J Zurmann, G Blumchen and W Merzkirch
Lehrstuhl fur Sromungslehre, Universitat Essen, Germany.
OBJECTIVE: Scant attention has been directed towards quantifying the degree
of mechanical disadvantage produced by akinetic and dyskinetic aneurysms.
The purpose of this study was to evaluate the mechanical disadvantages of
simulated akinetic and dyskinetic aneurysms on left ventricular function.
METHODS: An elaborate experimental apparatus consisting of a
computer-controlled water pressure chamber in which is suspended a model
rubber ventricle was developed. The system has been shown to reproduce
accurately the ventricular and aortic pressures found in vivo. In this
study, a procedure was designed to simulate akinetic and dyskinetic
aneurysms of various sizes on ventricular function. RESULTS: The results
indicated that an akinetic aneurysm produces little or no mechanical
disadvantage with respect to ventricular pressure since systolic paradox is
minimal. However, a dyskinetic aneurysm, irrespective of size, will usually
compromise ventricular function due to paradoxical systolic expansion in
the bulging aneurysmic sac. In vivo, other factors, such as blood
coagulation and rhythm disturbances, may influence these results.
CONCLUSIONS: An akinetic aneurysm causes little or no mechanical
disadvantage while the dyskinetic aneurysm, irrespective of size. will
restrict ventricular function. The experimental simulation system,
notwithstanding its limitations, thus provides a unique procedure to
quantify akinetic and dyskinetic aneurysms.
