PMID- 25488622
OWN - NLM
STAT- MEDLINE
DCOM- 20150413
LR  - 20191210
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 99
IP  - 2
DP  - 2015 Feb
TI  - Surgical ventricular restoration: is there any difference in outcome between 
      anterior and posterior remodeling?
PG  - 552-9
LID - S0003-4975(14)01720-2 [pii]
LID - 10.1016/j.athoracsur.2014.07.076 [doi]
AB  - BACKGROUND: The purpose of this study was to compare the early and long-term 
      outcomes in a consecutive population who underwent surgical ventricular 
      reconstruction (SVR) for either anterior or posterior remodeling. METHODS: Among 
      501 consecutive patients who underwent SVR at our institution between July 2001 
      and December 2011, 56 patients presented with posterior remodeling (group A; mean 
      age, 65 +/- 10 years), whereas anterior remodeling was evident in 445 patients 
      (group B; mean age, 65 +/- 9 years). The 2 groups were comparable regarding cardiac 
      risk factors and comorbidities. Patients in group A presented with larger left 
      ventricles, higher left ventricular (LV) cardiac mass, and higher ejection (EF) 
      and stroke volume (p = 0.01) compared with patients in group B. Moderate to 
      severe mitral regurgitation was present in 50% and 25% of patients in groups A 
      and B, respectively (p = 0.01). RESULTS: Thirty-day mortality was not 
      significantly different between the 2 groups (5.4% versus 8.3% in groups A and B, 
      respectively; p = 0.32). At logistic regression analysis, only preoperative age, 
      creatinine, and ejection fraction (ACEF) score was an independent predictor of 
      early mortality. Sixteen patients (29%) in group A and 92 patients (21%) in group 
      B died during follow-up (p = 0.12). Kaplan-Meier cumulative survival was 
      comparable between the 2 groups (log-rank p = 0.27). At multivariate Cox 
      regression analysis, preoperative age, advanced New York Heart Association (NYHA) 
      class, preoperative severe mitral regurgitation (MR), and preoperative tricuspid 
      annular plane systolic excursion (TAPSE) score less than 16 were independent 
      predictors of late mortality. CONCLUSIONS: Patients presenting with posterior 
      remodeling showed worse clinical signs of angina and congestive heart failure 
      (CHF) and a higher proportion of moderate to severe MR; however in the present 
      experience early and long-term outcomes after SVR seemed to be unaffected by 
      remodeling location.
CI  - Copyright (c) 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Garatti, Andrea
AU  - Garatti A
AD  - Department of Cardiac Surgery, I.R.C.C.S. Policlinico San Donato-San Donato 
      Milanese, Milan, Italy. Electronic address: andrea.garatti@grupposandonato.it.
FAU - Castelvecchio, Serenella
AU  - Castelvecchio S
AD  - Department of Cardiac Surgery, I.R.C.C.S. Policlinico San Donato-San Donato 
      Milanese, Milan, Italy.
FAU - Bandera, Francesco
AU  - Bandera F
AD  - Heart Failure Unit, I.R.C.C.S. Policlinico San Donato-San Donato Milanese, Milan, 
      Italy.
FAU - Guazzi, Marco
AU  - Guazzi M
AD  - Heart Failure Unit, I.R.C.C.S. Policlinico San Donato-San Donato Milanese, Milan, 
      Italy.
FAU - Menicanti, Lorenzo
AU  - Menicanti L
AD  - Department of Cardiac Surgery, I.R.C.C.S. Policlinico San Donato-San Donato 
      Milanese, Milan, Italy.
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20141206
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2015 Feb;99(2):559-60. PMID: 25639397
MH  - Aged
MH  - Cardiac Surgical Procedures/methods
MH  - Female
MH  - Heart Ventricles/*pathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ventricular Remodeling
EDAT- 2014/12/10 06:00
MHDA- 2015/04/14 06:00
CRDT- 2014/12/10 06:00
PHST- 2014/05/18 00:00 [received]
PHST- 2014/07/26 00:00 [revised]
PHST- 2014/07/30 00:00 [accepted]
PHST- 2014/12/10 06:00 [entrez]
PHST- 2014/12/10 06:00 [pubmed]
PHST- 2015/04/14 06:00 [medline]
AID - S0003-4975(14)01720-2 [pii]
AID - 10.1016/j.athoracsur.2014.07.076 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2015 Feb;99(2):552-9. doi: 10.1016/j.athoracsur.2014.07.076. 
      Epub 2014 Dec 6.