ENDOVENTRICULAR REMODELING OF LEFT-VENTRICULAR ANEURYSM - FUNCTIONAL,CLINICAL, AND ELECTROPHYSIOLOGICAL RESULTS

Citation
Ea. Grossi et al., ENDOVENTRICULAR REMODELING OF LEFT-VENTRICULAR ANEURYSM - FUNCTIONAL,CLINICAL, AND ELECTROPHYSIOLOGICAL RESULTS, Circulation, 92(9), 1995, pp. 98-100
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System",Hematology
Journal title
Circulation → ACNP
ISSN journal
0009-7322
Volume
92
Issue
9
Year of publication
1995
Supplement
S
Pages
98 - 100
Database
ISI
SICI code
0009-7322(1995)92:9<98:EROLA->2.0.ZU;2-G
Abstract
Background Recent advances in surgical techniques for the repair of le ft ventricular aneurysms (LVAs) include the use of an endoventricular patch to exclude the aneurysm cavity. This technique has replaced conv entional linear plication of the aneurysm. The endoventricular patch t echnique remodels the left ventricular cavity to a more physiological geometry that improves function. Methods and Results From December 198 9 through November 1993, 45 patients underwent an LVA repair with an e ndoventricular patch. This procedure was performed in association with coronary artery bypass grafting in 40 patients. Twenty-eight patients (62.2%) also had nonguided encircling subendocardial incisions. Opera tive procedures included 7 emergency operations, 3 concomitant valve p rocedures, and a mean of 2.2 bypass grafts per patient. Eight patients had previous cardiac operations. Hospital mortality was 15.6% (7/45) for all patients and 9.1% (3/33) for nonemergent revascularization and LVA repairs. Ejection fraction improved from a mean of 25.8% preopera tively to 37.8% postoperatively; the mean New York Heart Association c lassification improved from 3.5 to 1.5. Of patients known to have preo perative arrhythmias (inducible or sudden death), 69% were not inducib le postoperatively without antiarrhythmic medication. Survival from la te cardiac death (including death of unknown origin) was 86.5% at 2 ye ars. Freedom from documented ventricular arrhythmias was 94.3% at 2 ye ars. Conclusions These results indicate that the patch endoan-eurysmor rhaphy technique can provide an excellent functional and physiological outcome in patients with LVAs and severely impaired ventricular funct ion.