PMID- 7677076
OWN - NLM
STAT- MEDLINE
DCOM- 19951018
LR  - 20190622
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 76
IP  - 8
DP  - 1995 Sep 15
TI  - Outcome of left ventricular aneurysmectomy with patch repair in patients with 
      severely depressed pump function.
PG  - 557-61
AB  - To determine the efficacy of left ventricular (LV) aneurysm resection and 
      endoventricular patch repair with septal exclusion in patients with severely 
      depressed pump function, we retrospectively selected 62 patients (mean age 59 +/- 
      7 years) with preoperative LV ejection fraction < or = 20%, from a series of 322 
      patients with postinfarction LV aneurysm who underwent this type of surgery at 
      our center during a 5-year period. Mean ejection fraction was 17 +/- 3%; all 
      patients were in New York Heart Association (NYHA) class III/IV, and all had 
      hemodynamic and electrophysiologic studies before and after surgery. We analyzed 
      both operative and long-term survival, and hemodynamic, electrophysiologic, and 
      angiographic variables, as well as the symptomatic state after surgery. Follow-up 
      was available in all patients (mean 23 +/- 14 months). Subtotal endocardiectomy 
      and cryotherapy were associated in patients presenting with spontaneous or 
      inducible ventricular arrhythmias (VA). Hospital mortality rate was 19.3%. 
      Ejection fraction improved from 17 +/- 3% to 37 +/- 10% (p < 0.001); ventricular 
      arrhythmias decreased significantly after surgery. Factors influencing early 
      mortality at multivariate analysis were the presence of critical lesions on the 
      circumflex artery and the duration of cardiopulmonary bypass. At 1-year control, 
      a significant reduction in NYHA class was observed and no patient was in NYHA 
      class IV. The improvement in ejection fraction was maintained (39 +/- 11%), as 
      well as the reduction in inducible and spontaneous ventricular arrhythmias. There 
      were 5 late deaths at follow-up, accounting for a late mortality of 10% at 5 
      years.
FAU - Di Donato, M
AU  - Di Donato M
AD  - Department of Cardiology and Internal Medicine, University of Florence, Italy.
FAU - Sabatier, M
AU  - Sabatier M
FAU - Montiglio, F
AU  - Montiglio F
FAU - Maioli, M
AU  - Maioli M
FAU - Toso, A
AU  - Toso A
FAU - Fantini, F
AU  - Fantini F
FAU - Dor, V
AU  - Dor V
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Aneurysm/etiology/mortality/physiopathology/*surgery
MH  - Heart Ventricles/physiopathology/surgery
MH  - Hemodynamics
MH  - Humans
MH  - Internal Mammary-Coronary Artery Anastomosis/methods
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications
MH  - Retrospective Studies
MH  - Surgical Mesh
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/etiology/mortality/physiopathology/*surgery
EDAT- 1995/09/15 00:00
MHDA- 1995/09/15 00:01
CRDT- 1995/09/15 00:00
PHST- 1995/09/15 00:00 [pubmed]
PHST- 1995/09/15 00:01 [medline]
PHST- 1995/09/15 00:00 [entrez]
AID - S0002-9149(99)80154-4 [pii]
AID - 10.1016/s0002-9149(99)80154-4 [doi]
PST - ppublish
SO  - Am J Cardiol. 1995 Sep 15;76(8):557-61. doi: 10.1016/s0002-9149(99)80154-4.