| Partial left ventriculectomy for patients with ischemic cardiomyopathy. | |
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MedLine Citation:
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PMID: 11766833 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Partial left ventriculectomy (PLV) has been performed in patients with dilated cardiomyopathy (DCM), but improved myocardial energetics may make PLV useful also for ischemic cardiomyopathy (ICM) unamenable to conventional treatment. METHODS: Of 262 patients undergoing PLV, 94 patients with ICM as the underlying pathology were analyzed and compared with 168 patients with DCM. RESULTS: ICM patients were older (57.3 years vs 50.9 years, p = 0.0001) and heavier (69.7 kg vs 65.9 kg, p = 0.039) than those with DCM, but ventricular end-diastolic and end-systolic dimensions were similar with comparably depressed fractional shortening (16% vs 15%, p = 0.294) and equally severe functional limitation [New York Heart Association (NYHA) Class 3.7 vs 3.6, p = 0.734]. A majority of patients in both groups underwent lateral PLV (76% vs 74%, p = 0.883) with myocardium excised between papillary muscles and simultaneous mitral valvuloplasty (41% vs 74%, p < 0.0001). Because ICM patients required coronary artery bypass grafting (CABG) more frequently (79% vs 0.6%, p < 0.0001), operation was more extensive in terms of bypass time (74 minutes vs 47 minutes, p < 0.0001), percentage requiring cardiac arrest (43% vs 19%, p < 0.0001), and arrest duration (34 minutes vs 28 minutes, p = 0.280), but all had similar resection and postoperative ventricular dimensions. Nonetheless, ICM patients required shorter intensive care unit (ICU) time (4.4 days vs 5.9 days, p = 0.048) and similar postoperative hospital stays, resulting in similar hospital survival rates (69% vs 71%, p = 0.778) and functional capacity in long-term follow-up. CONCLUSIONS: Results suggest that PLV can be performed in patients with ICM with comparable risks and benefits as in DCM. Relative efficacy of CABG and mitral repair as compared to volume reduction remains to be studied. |
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Authors:
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T Fujimura; A T Kawaguchi; H Ishibashi-Ueda; J Bergsland; S Koide; R J Batista |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 16 ISSN: 0886-0440 ISO Abbreviation: J Card Surg Publication Date: 2001 Mar-Apr |
Date Detail:
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Created Date: 2001-12-19 Completed Date: 2002-03-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 145-52 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery and Transplantation, Tokai University, Bohseidai, Isehara, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiac Surgical Procedures / methods* Cardiomyopathy, Dilated / etiology, surgery* Female Heart Ventricles / surgery* Humans Male Middle Aged Myocardial Ischemia / complications* Retrospective Studies Risk Factors Severity of Illness Index Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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