PMID- 15262609
OWN - NLM
STAT- MEDLINE
DCOM- 20061213
LR  - 20221207
IS  - 1522-6662 (Electronic)
IS  - 1098-3511 (Linking)
VI  - 7
IP  - 3
DP  - 2004
TI  - Midterm results after septal reshaping for anteroseptal scars.
PG  - E230-6
AB  - BACKGROUND: Midterm clinical and morphologic results of the septal-reshaping 
      exclusion of anteroseptal dyskinetic or akinetic areas were evaluated. METHODS: 
      From January to June 2003, 44 patients with myocardial infarction following left 
      anterior descending coronary artery (LAD) occlusion underwent septal reshaping. 
      The mean (+/- SD) New York Heart Association (NYHA) class of the patients at 
      admission was 2.7 +/- 0.9. Angina was referred in 21 cases. The incision was 
      started at the apex and directed parallel to the LAD toward the base of the 
      heart. The septum was rebuilt with 1 or 2 U-stitches passed from the inside to 
      join the anterior wall to the septum by starting as high as possible where the 
      scar began and continuing in an oblique direction toward the new apex. An oval 
      polyethylene terephthalate fiber (Dacron) patch was then sutured from the septum 
      (at the end of the direct suture through the border with the inferior septum) to 
      the anterior wall (between the healthy wall and the scarred wall) and up to the 
      new apex. RESULTS: The 30-day mortality rate was 2.2% (1 patient, due to the 
      failure of a previously implanted defibrillator). Three patients experienced 
      acute renal failure. No patient had restrictive syndrome. After a mean follow-up 
      period of 8.5 +/- 4.9 months (range, 4-22 months), the mean NYHA class improved 
      from 2.7 +/- 0.9 to 1.6 +/- 0.5 (P < .001). The 18- month survival rate and the 
      probability of being alive in NYHA class I or II were 93.2% +/- 2.0% and 90.9% 
      +/- 4.3%, respectively. Echocardiographic results showed reductions in the left 
      ventricle volume with a normalization of the stroke volume. The diastolic 
      longitudinal length remained unchanged, and the diastolic sphericity index was 
      reduced but not significantly. CONCLUSIONS: At 1 year after surgery, the good 
      clinical and morphologic results demonstrate the safety and effectiveness of 
      septal reshaping for anteroseptal scars.
FAU - Calafiore, Antonio Maria
AU  - Calafiore AM
AD  - Division of Cardiac Surgery, University Hospital, Torino, Italy.
FAU - Di Mauro, Michele
AU  - Di Mauro M
FAU - Mazzei, Valerio
AU  - Mazzei V
FAU - Angelini, Gianni
AU  - Angelini G
FAU - Teodori, Giovanni
AU  - Teodori G
FAU - Wilde, Peter
AU  - Wilde P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Heart Surg Forum
JT  - The heart surgery forum
JID - 100891112
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiovascular Surgical Procedures/*methods
MH  - Cicatrix/*etiology/*surgery
MH  - Female
MH  - Heart Septum/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications/*surgery
MH  - Plastic Surgery Procedures/*methods
MH  - Treatment Outcome
EDAT- 2004/07/21 05:00
MHDA- 2006/12/14 09:00
CRDT- 2004/07/21 05:00
PHST- 2004/07/21 05:00 [pubmed]
PHST- 2006/12/14 09:00 [medline]
PHST- 2004/07/21 05:00 [entrez]
AID - 10.1532/HSF98.20041019 [doi]
PST - ppublish
SO  - Heart Surg Forum. 2004;7(3):E230-6. doi: 10.1532/HSF98.20041019.