PMID- 12757334
OWN - NLM
STAT- MEDLINE
DCOM- 20030910
LR  - 20190922
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 18
IP  - 2
DP  - 2003 Mar-Apr
TI  - Left ventricular aneurysmectomy: endoventricular circular patch plasty or 
      septoexclusion.
PG  - 93-100
AB  - BACKGROUND: Septoexclusion is a technique described by Guilmet in the mid 1980s. 
      Its indications and midterm results are evaluated and compared to those obtained 
      with the Dor operation. METHODS: From January 1998 to April 2001, 79 patients had 
      an exclusion of scars following myocardial infarction in left anterior descending 
      artery (LAD) territory. Fifty of them (63.3%) had the Dor operation (Group D) and 
      29 (36.7%) the Guilmet operation (Group G). Dor technique was used when the 
      involvement of the septum and the free wall was roughly similar. Guilmet 
      technique was indicated when the septum was involved at a greater extent than the 
      free wall. Ejection fraction (EF) was lower and end-diastolic volumes were higher 
      in Group G. Incidence of functional mitral regurgitation was similar in both 
      groups. RESULTS: Thirty-day mortality was 7.6% (8.0% in Group D versus 6.9% in 
      Group G, p = ns). After a mean of 21.0 +/- 8.5 months, five patients (6.9%) died, 
      two in Group D and three in Group G. Causes of death were cardiac related in four 
      and not cardiac related in one. Mean follow-up of the 68 survivors was 24.3 +/- 
      12.0 months (range: 4-38 months). Fifty patients (73.5% of the survivors) 
      improved (28 in Group D and 22 in Group G, p = 0.026), whereas in 18, New York 
      Heart Association (NYHA) class remained unchanged or worsened. Both groups showed 
      an increase of EF and a volumetric reduction, whereas stroke volume remained 
      unchanged. Fewer patients had mitral regurgitation than in the preoperative 
      period (41.3% versus 65.8%, p = 0.013) and at a lesser extent (1.7 +/- 0.7 versus 
      0.7 +/- 0.6, p < 0.001). CONCLUSIONS: Our results show that both Dor and Guilmet 
      techniques are effective in the surgical treatment of left ventricular dyskinetic 
      or akinetic areas related to LAD territory. Each technique has its own 
      indications and has to be addressed to patients with different extension of 
      septal scars.
FAU - Calafiore, Antonio Maria
AU  - Calafiore AM
AD  - Department of Cardiology and Cardiac Surgery, University G. D'Annunzio, S. 
      Camillo de' Lellis Hospital, Chieti, Italy. calafiore@unich.it
FAU - Gallina, Sabina
AU  - Gallina S
FAU - Di Mauro, Michele
AU  - Di Mauro M
FAU - Pano, Marco
AU  - Pano M
FAU - Teodori, Giovanni
AU  - Teodori G
FAU - Di Giammarco, Gabriele
AU  - Di Giammarco G
FAU - Contini, Marco
AU  - Contini M
FAU - Iaco, Angela L
AU  - Iaco AL
FAU - Vitolla, Giuseppe
AU  - Vitolla G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Aged
MH  - Cardiac Surgical Procedures/*methods/mortality
MH  - Cardiomyoplasty/methods/mortality
MH  - Echocardiography, Transesophageal/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Aneurysm/*diagnosis/etiology/mortality/*surgery
MH  - Heart Function Tests
MH  - Heart Ventricles/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications/diagnosis
MH  - Postoperative Complications/mortality
MH  - Probability
MH  - Radiography
MH  - Radionuclide Ventriculography/methods
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/diagnostic imaging/mortality/surgery
EDAT- 2003/05/22 05:00
MHDA- 2003/09/11 05:00
CRDT- 2003/05/22 05:00
PHST- 2003/05/22 05:00 [pubmed]
PHST- 2003/09/11 05:00 [medline]
PHST- 2003/05/22 05:00 [entrez]
AID - 10.1046/j.1540-8191.2003.02016.x [doi]
PST - ppublish
SO  - J Card Surg. 2003 Mar-Apr;18(2):93-100. doi: 10.1046/j.1540-8191.2003.02016.x.