@entity1002 with predominating XXXX . A comparative study of medical and surgical treatment.

@entity1 @entity712 @entity299 @entity439 @entity1188 @entity1167 @entity453 @entity67 @entity1455 @entity204 @entity1002
From 1979 to 1985, 109 @entity1 were treated for @entity712 caused by postinfarction @entity1002 . @entity712 was predominant in all @entity1 at the time of diagnosis, 73% of whom were in Functional Class III or IV. Left ventricular end-diastolic pressure averaged 23.8 +/- 0.8 mm Hg (mean +/- standard error of the mean), total ejection fraction 29.7% +/- 1.0%, and telediastolic volume of the @entity439 76.2 +/- 5.8 ml. Aneurysmectomy was performed in 49 @entity1 (45%), whereas the remaining 60 @entity1 were treated medically. The two groups did not differ in regard to clinical and hemodynamic data on admission, except for a more extensive @entity453 in the surgical group. Follow-up was obtained for all @entity1 (100%) and averaged 48 +/- 3 months. Actuarial survival curves were similar, and the 5-year survival rates for surgical and medical groups were 70 +/- 7% and 64% +/- 7%, respectively (not significant). However, the 5-year complication-free rate was significantly (p = 0.05) higher among surgical @entity1 (52% +/- 8%) than among the medical group (31% +/- 7%). Multivariate analysis showed the following variables to influence survival independently (p less than 0.05): contractile segment ejection fraction, @entity67 , antecedents of @entity1167 or @entity1455 , and corrected contractile score. Independent variables decreasing the risk of @entity299 and @entity204 (p less than 0.05) were as follows: surgical treatment, shorter interval between initial @entity1188 and diagnosis of @entity439 , and absence of @entity67 . Functional improvement was directly related to surgical treatment and to residual segment contractile score (p less than 0.05). Thus, in @entity1 with @entity712 caused by @entity1002 , surgical treatment improved the quality of life and prognosis for @entity299 , but did not increase overall survival, compared to medical management of similar @entity1 .
