Document Detail

Autopsy findings in early and late postoperative death after partial left ventriculectomy.
MedLine Citation:
PMID:  10750759     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Partial left ventriculectomy (PLV) is an alternative to heart transplantation for patients with severe heart failure. However, this procedure is accompanied by high morbidity and mortality. Therefore, we studied the hearts of 12 patients who underwent this procedure to increase our understanding of the causes of bad outcome. METHODS: We analyzed the autopsy hearts of 11 of 16 patients who died after PLV, and one heart from a patient who underwent heart transplantation. RESULTS: Six patients died less than 30 days postoperatively, 4 of cardiogenic shock, 1 of arrhythmia, and 1 of coagulopathy. Five patients died from 36 to 120 days after the procedure, 4 of cardiogenic shock and 1 of arrhythmia. The patient who underwent heart transplantation had a cardiogenic shock 230 days after PLV. Ten hearts weighed more than 500 g and nine had myocardial infarction that extended to the papillary muscles. Four patients had infarction of both papillary muscles and 3 of them had episodes of arrhythmia, suggesting some relation between these events. CONCLUSIONS: We found several important morphologic clues for bad outcome: infarction of both papillary muscles, which may be associated with the development of arrhythmia, and myocardial infarction and pericardial hemorrhage, which may contribute to the outcome of heart failure.
P M Cury; M L Higuchi; P S Gutierrez; L F Moreira; E A Bocchi; N A Stolf; A D Jatene
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  69     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-04-27     Completed Date:  2000-04-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  769-73     Citation Subset:  AIM; IM    
Heart Institute (InCor), University of São Paulo Medical School, SP, Brazil.
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MeSH Terms
Cardiac Surgical Procedures / adverse effects*,  methods
Cardiomyopathy, Dilated / surgery*
Heart Ventricles / pathology*,  surgery*
Middle Aged
Postoperative Complications / epidemiology
Postoperative Period
Time Factors
Treatment Failure
Comment In:
Ann Thorac Surg. 2001 Jun;71(6):2088   [PMID:  11426822 ]
Ann Thorac Surg. 2000 Dec;70(6):2185   [PMID:  11156156 ]

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