Document Detail


Mathematical modelling to identify patients who should not undergo left ventricle remodelling surgery.
MedLine Citation:
PMID:  20093268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A mathematical model was developed to predict the cardiac output post left ventricle volume reduction surgery (LVVRS) to establish who should not undergo surgery. Two scenarios were evaluated: dilated cardiomyopathy (DCM), and left ventricular wall aneurysm (LVA). In DCM, a left ventricular diastolic volume (LVDV) of 380 ml, ejection fraction (EF) of 15%, and a heart rate of 80, produces a cardiac output of 4.5 l/min. After LVVRS for DCM to reduce the LV volume to 315 ml, the EF is unchanged, but the cardiac output drops by 0.7 l/min. In LV aneurysms, a LVDV of 380 ml, EF of 15%, and a heart rate of 80, produces a cardiac output of 4.5 l/min. After LVVRS for LVA reducing the LV volume to 320 ml, the EF increases to 56%, and the predicted cardiac output doubles. LVVRS is potentially very hazardous in the setting of DCM, confirmed by the international registry report and the Surgical Treatment for Ischemic Heart Failure Trial. However, in the setting of LVA, the surgery can result in marked improvement in cardiac output. The effect on postoperative cardiac output, due to the extent of LV resection can potentially be modelled for preoperatively.
Authors:
Richard Warwick; Mark Pullan; Michael Poullis
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-01-21
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  10     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-08-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  661-5     Citation Subset:  IM    
Copyright Information:
2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
Affiliation:
Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE, UK.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / methods*,  mortality
Cardiomyopathy, Dilated / diagnosis
Female
Finite Element Analysis
Follow-Up Studies
Heart Aneurysm / diagnosis,  mortality,  surgery*
Heart Function Tests
Heart Ventricles / surgery*
Humans
Male
Models, Theoretical*
Myocardial Contraction / physiology
Patient Selection*
Predictive Value of Tests
Risk Assessment
Stroke Volume
Survival Rate
Treatment Outcome
Ventricular Dysfunction, Left / diagnosis,  mortality,  surgery
Ventricular Remodeling / physiology*
Comments/Corrections
Comment In:
Interact Cardiovasc Thorac Surg. 2010 May;10(5):665   [PMID:  20403981 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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