Document Detail


Partial left ventriculectomy for patients with ischemic cardiomyopathy.
MedLine Citation:
PMID:  11766833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
T Fujimura; A T Kawaguchi; H Ishibashi-Ueda; J Bergsland; S Koide; R J Batista
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  16     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2001 Mar-Apr
Date Detail:
Created Date:  2001-12-19     Completed Date:  2002-03-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  145-52     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery and Transplantation, Tokai University, Bohseidai, Isehara, Japan.
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MeSH Terms
Descriptor/Qualifier:
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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