PMID- 19781378
OWN - NLM
STAT- MEDLINE
DCOM- 20100204
LR  - 20090928
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Linking)
VI  - 122
IP  - 17
DP  - 2009 Sep 5
TI  - Repair of left ventricular aneurysm: ten-year experience in Chinese patients.
PG  - 1963-8
AB  - BACKGROUND: A large transmural myocardial infarction often results in a 
      dyskinetic or akinetic left ventricular aneurysm (LVA). This study aimed to 
      explore the early and long-term clinical outcomes and to identify predictors for 
      survivals and hospital re-admission after the repair of left ventricular 
      aneurysm. METHODS: We followed up 497 patients who had undergone LVA repair from 
      a single center in China between 1995 and 2005. The perioperative parameters were 
      recorded. Risk factors for early mortality and long-term results were analyzed by 
      multivariate Logistic regression. Cox's proportional hazard model was used to 
      calculate risk factors for major adverse cardiac and cerebrovascular events, 
      cause of death and re-admission. Kaplan-Meier curve was employed to analyze 
      long-term survival. RESULTS: The operative mortality was 2.0%. The long-term 
      mortality was 11.1% and cardiac causes contributed to 61.8% of the overall 
      long-term mortality. Four hundred and thirty-two patients survived during the 
      follow-up period and 37.5% of them had been re-admitted at least one time. One 
      hundred and five patients experienced major adverse cardiac and cerebrovascular 
      events. Survival analysis exhibited that the probability of survival at 1 and 5 
      years after operation was 96% and 86% respectively. Previous atrial fibrillation 
      was the independent risk factor for early mortality. Independent risk factors for 
      long-term mortality were poor left ventricular ejection fraction and stroke,and 
      risk factors for cardiac mortality were intraventricular block, stroke and poor 
      left ventricular ejection fraction. Stroke, intraventricular block and advanced 
      age were independent risk factors for major adverse cardiac and cerebrovascular 
      events, and New York Heart Association (NYHA) class III-IV was the only risk 
      factor for hospital re-admission. CONCLUSIONS: Postinfarction LVA can be repaired 
      and satisfying early and long-term clinical outcome can be obtained. 
      Endoventricular circular plasty technique is the better choice than linear repair 
      in patients with large LVA. Survival is affected in patients with poor heart 
      function, intraventricular block and stroke.
FAU - Fan, Hong-guang
AU  - Fan HG
AD  - Department of Cardiovascular Surgery, Center for Cardiovascular Regenerative 
      Medicine, Fu Wai Hospital, Peking Union Medical College and Chinese Academic of 
      Medical Sciences, Beijing 100037, China.
FAU - Zheng, Zhe
AU  - Zheng Z
FAU - Feng, Wei
AU  - Feng W
FAU - Yuan, Xin
AU  - Yuan X
FAU - Wang, Wei
AU  - Wang W
FAU - Hu, Sheng-shou
AU  - Hu SS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Aneurysm/mortality/pathology/*surgery
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/physiopathology/surgery
MH  - Proportional Hazards Models
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/pathology/*surgery
EDAT- 2009/09/29 06:00
MHDA- 2010/02/05 06:00
CRDT- 2009/09/29 06:00
PHST- 2009/09/29 06:00 [entrez]
PHST- 2009/09/29 06:00 [pubmed]
PHST- 2010/02/05 06:00 [medline]
PST - ppublish
SO  - Chin Med J (Engl). 2009 Sep 5;122(17):1963-8.