Document Detail


Mitral valve annuloplasty and myocardial revascularization in the treatment of ischemic dilated cardiomyopathy.
MedLine Citation:
PMID:  16440145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to examine perioperative mortality and morbidity and midterm results in patients undergoing coronary bypass graft and mitral valve annuloplasty with advanced dilated cardiomyopathy. Sixty-one patients with ischemic dilated cardiomyopathy underwent coronary artery bypass grafting and mitral valve annuloplasty between January 1998 and December 2003. Patients eligible for revascularization that presented a mild or more severe mitral valve regurgitation at echocardiography (effective regurgitant orifice > 0.2 cm(2)) were considered for annuloplasty with a Cosgrove ring. New York Heart Association class (NYHA) III/IV was present in 40 patients (66%) and Canadian Cardiovascular Society class III-IV in 19 (31%). A previous acute myocardial infarction was reported in 48 patients (79%). The mean number of graft anastomoses was 2.5 +/- 0.7 and the left internal mammary artery was used in 49 patients (80%). In-hospital mortality was 4.9% (3 patients), due to unsuccessful weaning from cardiopulmonary bypass, multiple organ failure, and stroke, respectively. Left ventricle ejection fraction improved from 28.9% +/- 5.2% preoperatively to 35.4% +/- 8.1% at follow-up (P = 0.0001) and a significant reduction in NYHA III/IV was detected: from 40 patients preoperatively (66%) to 14 (31%) at follow-up (P = 0.031). Midterm cardiac-related mortality rate was 3.4%. In our experience combined coronary artery bypass grafting and ring annuloplasty for ischemic dilated cardiomyopathy can be performed with acceptable risks for in-hospital mortality and morbidity. Midterm results show a good survival rate and a durable functional improvement in this subset of patients.
Authors:
Francesco Nicolini; Giampaolo Zoffoli; Giovanni Cagnoni; Andrea Agostinelli; Andrea Colli; Claudio Fragnito; Bruno Borrello; Cesare Beghi; Tiziano Gherli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart and vessels     Volume:  21     ISSN:  0910-8327     ISO Abbreviation:  Heart Vessels     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-27     Completed Date:  2007-08-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  28-32     Citation Subset:  IM    
Affiliation:
Cardiac Surgery Department, University of Parma, Parma, Italy. francesconicolini@libero.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiomyopathy, Dilated / mortality,  physiopathology,  surgery*,  ultrasonography
Coronary Artery Bypass*
Echocardiography
Female
Follow-Up Studies
Heart Valve Prosthesis Implantation*
Hospital Mortality
Humans
Internal Mammary-Coronary Artery Anastomosis
Italy
Male
Middle Aged
Mitral Valve Insufficiency / mortality,  physiopathology,  surgery*,  ultrasonography
Myocardial Ischemia / mortality,  physiopathology,  surgery*,  ultrasonography
Severity of Illness Index
Stroke Volume
Survival Rate
Treatment Outcome
Ventricular Dysfunction, Left / mortality,  physiopathology,  surgery,  ultrasonography

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


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