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Improved cardiac function following left ventricular aneurysm resection: pre- and postoperative performance studies in 150 patients.
MedLine Citation:
PMID:  15226926     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
One hundred fifty patients underwent radionuclide left ventricular performance studies before and one week after resection of a left ventricular aneurysm. The patients were classified according to pre-and postoperative ejection fraction into five classes as follows: Class I > 50%, Class II = 41%-50%, Class III = 31%-40%, Class IV = 21%-30%, and Class V = < 21%. They were also classified into groups according to the size of the aneurysm and wall thickness. Operative mortality was 4.6% (7/150). One hundred one patients (67%) improved at least one "ejection-fraction class" postoperatively; whereas in a similar group of patients who underwent aortocoronary bypass without left ventricular aneurysm resection, only 42.3% (58/137) improved (p <.01). Preoperatively, ejection fraction was < 40% in 136 patients (90.6%); and postoperatively, it was > 40% in 59 patients (39.3%) (p <.01). Improvement of at least one "ejection-fraction class" occurred in 22 patients (47.8%) with small aneurysms, 54 patients (69.2%) with moderate size aneurysms (p <.05), and 25 patients (96.1%) with large aneurysms (p <.01). Sixty-nine patients (88.4%) with thin-walled aneurysms and 32 patients (44.4%) with thick-walled aneurysms improved (p <.01). Resection of a left ventricular aneurysm improves left ventricular function, particularly in patients with large, thin-walled aneurysms. A less aggressive surgical approach is warranted when dealing with thick-walled akinetic areas as patients with these lesions do not respond well to resection.
Authors:
D A Ott; R Parravacini; D A Cooley; E G DePuey; G J Reul; J M Duncan; O H Frazier; J J Livesay
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  9     ISSN:  0730-2347     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  1982 Sep 
Date Detail:
Created Date:  2004-06-30     Completed Date:  2005-02-02     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  267-73     Citation Subset:  -    
Affiliation:
Divisions of Surgery and Nuclear Medicine of the Texas Heart Institute of St. Luke's Episcopal and Texas Children's Hospitals, Houston, Texas 77225-0345, USA.
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