Document Detail


Off-pump anteroapical aneurysm plication following left ventricular postinfarction aneurysm: effect on cardiac function, clinical status and survival.
MedLine Citation:
PMID:  23351499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In patients with coronary disease and aneurysm, ventricular reconstruction with revascularization is a surgical option. Details of patient selection and optimal surgical technique are still debated. We report our results with off-pump aneurysm plication after ventricular aneurysm with relative wall thinning.
METHODS: We retrospectively reviewed the records of 248 patients who had an operation for postinfarction left ventricular aneurysm. Reconstruction was accomplished by off-pump anteroapical aneurysm plication. The following variables were recorded: preoperative clinical, angiographic and echocardiographic findings and operative procedures. Outcomes were early mortality, long-term survival and poor 5-year result, defined as the need for transplantation or repeated hospitalization for congestive heart failure. Risk factors were pinpointed using the t test and survival curves. Independent risk factors were identified using Cox regression methods.
RESULTS: Hospital mortality was low (2.0%). Mean follow-up was 5.8 (standard deviation [SD] 3.8) years. Actuarial survival at 1 and 5 years was 94% and 84%. Among the 232 survivors, 200 were in functional class I or II, and the average increase in ejection fraction was 14.0% (SD 3.1%). As determined by multivariable analysis, factors predicting poor outcome were advanced age, ejection fraction less than 0.35, conicity index less than 1, end-systolic volume index greater than 80 mL/m2, advanced New York Heart Association functional class and congestive heart failure.
CONCLUSION: Using wall thinning as a criterion for patient selection, the technique of off-pump anteroapical aneurysm plication can be performed with low operative mortality and provides good symptomatic relief and long-term survival.
Authors:
Xin-sheng Huang; Cheng-xiong Gu; Jun-feng Yang; Hua Wei; Jing-xing Li; Qi-wen Zhou
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  56     ISSN:  1488-2310     ISO Abbreviation:  Can J Surg     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-22     Completed Date:  2013-05-16     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  119-27     Citation Subset:  IM    
Affiliation:
The Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Surgical Procedures
Coronary Artery Bypass, Off-Pump
Female
Heart Aneurysm / etiology,  pathology,  surgery*
Heart Ventricles
Hospital Mortality
Hospitalization
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / complications
Retrospective Studies
Risk Factors
Stroke Volume
Treatment Outcome
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