Document Detail

Mitral valve annuloplasty and myocardial revascularization in the treatment of ischemic dilated cardiomyopathy.
MedLine Citation:
PMID:  16440145     Owner:  NLM     Status:  MEDLINE    
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.
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    
Cardiac Surgery Department, University of Parma, Parma, Italy.
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MeSH Terms
Cardiomyopathy, Dilated / mortality,  physiopathology,  surgery*,  ultrasonography
Coronary Artery Bypass*
Follow-Up Studies
Heart Valve Prosthesis Implantation*
Hospital Mortality
Internal Mammary-Coronary Artery Anastomosis
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

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