Document Detail


Repair of left ventricular aneurysm: ten-year experience in Chinese patients.
MedLine Citation:
PMID:  19781378     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A large transmural myocardial infarction often results in a dyskinetic or akinetic left ventricular aneurysm (LVA). This study aimed to explore the early and long-term clinical outcomes and to identify predictors for survivals and hospital re-admission after the repair of left ventricular aneurysm. METHODS: We followed up 497 patients who had undergone LVA repair from a single center in China between 1995 and 2005. The perioperative parameters were recorded. Risk factors for early mortality and long-term results were analyzed by multivariate Logistic regression. Cox's proportional hazard model was used to calculate risk factors for major adverse cardiac and cerebrovascular events, cause of death and re-admission. Kaplan-Meier curve was employed to analyze long-term survival. RESULTS: The operative mortality was 2.0%. The long-term mortality was 11.1% and cardiac causes contributed to 61.8% of the overall long-term mortality. Four hundred and thirty-two patients survived during the follow-up period and 37.5% of them had been re-admitted at least one time. One hundred and five patients experienced major adverse cardiac and cerebrovascular events. Survival analysis exhibited that the probability of survival at 1 and 5 years after operation was 96% and 86% respectively. Previous atrial fibrillation was the independent risk factor for early mortality. Independent risk factors for long-term mortality were poor left ventricular ejection fraction and stroke,and risk factors for cardiac mortality were intraventricular block, stroke and poor left ventricular ejection fraction. Stroke, intraventricular block and advanced age were independent risk factors for major adverse cardiac and cerebrovascular events, and New York Heart Association (NYHA) class III-IV was the only risk factor for hospital re-admission. CONCLUSIONS: Postinfarction LVA can be repaired and satisfying early and long-term clinical outcome can be obtained. Endoventricular circular plasty technique is the better choice than linear repair in patients with large LVA. Survival is affected in patients with poor heart function, intraventricular block and stroke.
Authors:
Hong-guang Fan; Zhe Zheng; Wei Feng; Xin Yuan; Wei Wang; Sheng-shou Hu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chinese medical journal     Volume:  122     ISSN:  0366-6999     ISO Abbreviation:  Chin. Med. J.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-28     Completed Date:  2010-02-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513795     Medline TA:  Chin Med J (Engl)     Country:  China    
Other Details:
Languages:  eng     Pagination:  1963-8     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Center for Cardiovascular Regenerative Medicine, Fu Wai Hospital, Peking Union Medical College and Chinese Academic of Medical Sciences, Beijing 100037, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Heart Aneurysm / mortality,  pathology,  surgery*
Humans
Logistic Models
Male
Middle Aged
Myocardial Infarction / mortality,  physiopathology,  surgery
Proportional Hazards Models
Survival Analysis
Treatment Outcome
Ventricular Dysfunction, Left / pathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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