Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2009
Left ventricular reconstruction with or without mitral annuloplasty.
СтатьяНазвание и аннотация: Перевод в очереди
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Ueno Tetsuya, Sakata Ryuzo, Iguro Yoshifumi, Yamamoto Hiroyuki, Ueno Masahiro, Ueno Takayuki, Matsumoto Kazuhisa, Hisashi Yosuke, Tei Chuwa
Аннотация
OBJECTIVES: The aim of this study was to review characteristics of patients undergoing left ventricular reconstruction (LVR) with or without mitral annuloplasty (MAP) for postinfarction ventricular remodeling.
PATIENTS AND METHODS: Forty-seven patients were divided into two groups: LVR (LVR group, n = 22) and LVR with MAP (LVRM group, n = 25). Echocardiographic parameters including left ventricular (LV) dimensions, LV end-diastolic and end-systolic volume indexes, and LV ejection fraction (LVEF) at immediate and midterm postoperative stages were evaluated. The perioperative contributing factors to all deaths and death from congestive heart failure (CHF) were analyzed in all 47 patients.
RESULTS: Patients in the LVRM group had greater preoperative LV dimension and volume, and significantly lower LVEF, with notably frequent use of intra-aortic balloon pumping. All postoperative deaths occurred within 1 year from surgery. The LV end-diastolic volume > 110 ml/m2 and creatinine > 1.2 mg/dl were significant preoperative contributing factors to all deaths, and the latter was to CHF deaths.
CONCLUSIONS: The coexistence of ischemic mitral regurgitation with LV dilatation required more aggressive surgical approaches for the patients with more impaired LV function. More intensive postoperative management is required for patients with enlarged hearts and renal dysfunctions.
PATIENTS AND METHODS: Forty-seven patients were divided into two groups: LVR (LVR group, n = 22) and LVR with MAP (LVRM group, n = 25). Echocardiographic parameters including left ventricular (LV) dimensions, LV end-diastolic and end-systolic volume indexes, and LV ejection fraction (LVEF) at immediate and midterm postoperative stages were evaluated. The perioperative contributing factors to all deaths and death from congestive heart failure (CHF) were analyzed in all 47 patients.
RESULTS: Patients in the LVRM group had greater preoperative LV dimension and volume, and significantly lower LVEF, with notably frequent use of intra-aortic balloon pumping. All postoperative deaths occurred within 1 year from surgery. The LV end-diastolic volume > 110 ml/m2 and creatinine > 1.2 mg/dl were significant preoperative contributing factors to all deaths, and the latter was to CHF deaths.
CONCLUSIONS: The coexistence of ischemic mitral regurgitation with LV dilatation required more aggressive surgical approaches for the patients with more impaired LV function. More intensive postoperative management is required for patients with enlarged hearts and renal dysfunctions.
Предметные рубрики MeSH
AgedCoronary Artery BypassFemaleHeart FailureHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHeart VentriclesHumansHypertrophy, Left VentricularKidney DiseasesMaleMiddle AgedMitral Valve InsufficiencyMyocardial InfarctionProsthesis DesignRegression AnalysisRetrospective StudiesRisk AssessmentRisk FactorsStroke VolumeTime FactorsTreatment OutcomeVentricular Function, LeftVentricular Remodeling