PMID- 21211314
OWN - NLM
STAT- MEDLINE
DCOM- 20110915
LR  - 20110107
IS  - 0376-2491 (Print)
IS  - 0376-2491 (Linking)
VI  - 90
IP  - 42
DP  - 2010 Nov 16
TI  - [Clinical analyses of cardiovascular operations in patients with severe dilated 
      left ventricle].
PG  - 2999-3002
AB  - OBJECTIVE: To explore the perioperative features of surgical treatment in 
      valvular patients with severe dilated left ventricle and investigate the 
      structural changes of left ventricle and its correlation with cardiac functions. 
      METHODS: A total of 126 patients with severe dilated left ventricle underwent 
      mitral valve and/or aortic valve operation from January 2003 to December 2008, 
      including mitral valve replacement (MVR) (n = 27), mitral valvuloplasty (MVP) (n 
      = 13), aortic valve replacement (AVR) (n = 51), AVR+MVR (n = 25) and AVR + MVP (n 
      = 10). There were 79 males and 47 females with a mean age of (52 +/- 13) years old. 
      The mean pathological course was (18 +/- 12) years. The pathological changes were 
      mainly of aortic and/or mitral incompetence. The concomitant procedures included 
      Bentall procedure (n = 6), coronary artery bypass grafting (n = 3), tricuspid 
      valvuloplasty (n = 58) and left atrial folding (n = 62). RESULTS: The 
      perioperative mortality was 3.17% (4/126). Two died of multiple organ failure 
      (MOF) secondarily to severe low-output syndrome while another 2 died of sudden 
      ventricular fibrillation. Forty-six (36.5%) patients suffered from ventricular 
      arrhythmia during the earlier postoperative period and they required a venous 
      injection of lidocaine and/or amiodarone. Fourteen (11.1%) patients suffered from 
      severe low-output syndrome. Among them, 4 patients were resuscitated with an 
      intra-aortic balloon pump for another 4 - 6 days. And 26 (20.6%) cases were 
      complicated with multiple organ failure. The echocardiographic examinations 
      showed that left ventricular dimensions decreased significantly at Days 7 - 14 
      postoperatively and progressively at Months 6 - 12 postoperatively. Left 
      ventricular end-diastolic diameter (LVEDD) was (77 +/- 6) mm preoperatively and (63 
      +/- 12) mm (Days 7 - 14), (58 +/- 10) mm (Months 6 - 12) postoperatively (P < 0.01). 
      The contractile function of left ventricle temporarily decreased during the early 
      postoperative stage and improved gradually afterwards. But it was not restored to 
      normal range even until 6 - 12 m post-operation. Ejection fraction was 49% +/- 12% 
      preoperatively and 42% +/- 9% (Days 7 - 14), 51% +/- 7% (Months 6 - 12) 
      postoperatively (P < 0.01). Left ventricular fraction shortness was 28% +/- 7% 
      preoperatively and 25% +/- 4% (Days 7 - 14), 29% +/- 5% (Months 6 - 12) 
      postoperatively (P < 0.05). CONCLUSION: For the patients with severe dilated left 
      ventricle, cardiovascular operation can achieve an excellent outcome through a 
      rigorous perioperative regiment. The prevention and treatment of postoperative 
      ventricular arrhythmia should be emphasized. The dimension of left ventricle 
      decreases progressively during the early postoperative period. There is a 
      postoperative decline of cardiac functions.
FAU - Jiang, Sheng-li
AU  - Jiang SL
AD  - Department of Cardiaovascular Surgery, Chinese PLA Cardiac Surgery Institute, 
      Beijing 100853, China. jiangsl301@sina.com
FAU - Li, Bo-jun
AU  - Li BJ
FAU - Gao, Chang-qing
AU  - Gao CQ
FAU - Ren, Chong-lei
AU  - Ren CL
FAU - Wang, Yao
AU  - Wang Y
FAU - Cheng, Ting-ting
AU  - Cheng TT
FAU - Zhang, Tao
AU  - Zhang T
FAU - Zhao, Tao
AU  - Zhao T
FAU - Zhang, Lin
AU  - Zhang L
LA  - chi
PT  - English Abstract
PT  - Journal Article
PL  - China
TA  - Zhonghua Yi Xue Za Zhi
JT  - Zhonghua yi xue za zhi
JID - 7511141
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Surgical Procedures
MH  - Female
MH  - Heart Valve Diseases/*pathology/*surgery
MH  - Heart Valve Prosthesis Implantation
MH  - Heart Ventricles/*pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Young Adult
EDAT- 2011/01/08 06:00
MHDA- 2011/09/16 06:00
CRDT- 2011/01/08 06:00
PHST- 2011/01/08 06:00 [entrez]
PHST- 2011/01/08 06:00 [pubmed]
PHST- 2011/09/16 06:00 [medline]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi. 2010 Nov 16;90(42):2999-3002.