Document Detail


Patch size, shape and orientation affect geometrical outcomes of surgical anterior ventricular restoration.
MedLine Citation:
PMID:  18334894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  9     ISSN:  1558-2027     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-12     Completed Date:  2008-06-26     Revised Date:  2009-05-28    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  389-95     Citation Subset:  IM    
Affiliation:
Heart Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy. cirillo-marco@poliambulanza.it
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MeSH Terms
Descriptor/Qualifier:
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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