| Patch size, shape and orientation affect geometrical outcomes of surgical anterior ventricular restoration. | |
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MedLine Citation:
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PMID: 18334894 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To verify whether the use of a small, oval-shaped patch limits the trend toward re-dilatation compared to endoventricular circular patch plasty and leads to different geometrical and functional results in surgical anterior restoration. METHODS: Thirty-seven patients with ischemic cardiomyopathy after anterior myocardial infarction end-systolic volume index of > or =45 ml/m2, ejection fraction of < or =35%, and no combined mitral procedures, underwent surgical anterior ventricular restoration between January 2000 and April 2003: 18 patients (group 1) were operated on using the endoventricular circular patch plasty technique (mean patch area 9.6 cm2) and 19 patients (group 2) received a small, obliquely oriented, oval-shaped patch (mean patch area 6.2 cm2). Ten geometrical parameters were studied preoperatively and at least 6 and 12 months after surgery. Data were analyzed using repeated-measures ANOVA, chi2, paired and unpaired Student's t-test, and binary logistic regression. RESULTS: Group 1 showed a worsening over time in systolic and diastolic longitudinal length, end-diastolic volume (P < 0.001), end-diastolic volume index (P = 0.006), end-systolic volume (P = 0.005), and end-systolic volume index (P = 0.03). Group 2 showed an improvement in percentage of akinesia and wall motion score index (P < 0.001) and a worsening only in end-systolic diameter (P = 0.03) and end-diastolic volume (P = 0.04). At 12-month follow-up, ANOVA revealed that the oval patch positively influenced end-diastolic volume (P = 0.03), end-systolic volume (P = 0.03), and end-systolic volume index (P = 0.05), and group 2 had a significantly higher number of patients with an end-systolic volume index of <45 ml/m2 (P = 0.01). CONCLUSION: The use of a small, narrow, obliquely oriented, oval patch may help to prevent adverse ventricular remodeling over time. |
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Authors:
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Marco Cirillo; Andrea Amaducci; Eugenio Quaini; Emmanuel Villa; Margherita Dalla Tomba; Zean Mhagna; Federico Brunelli; Antonio Messina; Giovanni Troise |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiovascular medicine (Hagerstown, Md.) Volume: 9 ISSN: 1558-2027 ISO Abbreviation: J Cardiovasc Med (Hagerstown) Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-03-12 Completed Date: 2008-06-26 Revised Date: 2009-05-28 |
Medline Journal Info:
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Nlm Unique ID: 101259752 Medline TA: J Cardiovasc Med (Hagerstown) Country: United States |
Other Details:
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Languages: eng Pagination: 389-95 Citation Subset: IM |
Affiliation:
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Heart Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy. cirillo-marco@poliambulanza.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Animals Bioprosthesis* Cardiac Surgical Procedures / methods Cattle Chi-Square Distribution Coronary Artery Bypass Echocardiography Female Heart Ventricles / surgery* Humans Logistic Models Male Middle Aged Myocardial Infarction / complications* Myocardial Ischemia / etiology, physiopathology, surgery*, ultrasonography Pilot Projects Treatment Outcome Ventricular Remodeling |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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