| A critical evaluation of results of partial left ventriculectomy. | |
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MedLine Citation:
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PMID: 12809396 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Because of the variation in the surgical procedures designed to reduce ventricular radius, along with differences in hospital care, it is difficult to disentangle the factors that may contribute to the success or failure of the partial left ventriculectomy. METHODS AND RESULTS: We undertook partial left ventriculectomy in 18 patients, 10 suffering from idiopathic dilated cardiomyopathy and 8 from ischemic heart disease. We assessed the amount of reduction in wall stress, the systolic thickening of the ventricular wall, and the extent of connective tissue in the excised segment of the wall. Of the overall group, six patients died, three from infarction, one of stroke, one with asystole, and one with ventricular fibrillation. The mean decrease in measured mesh tension was 40% (p < 0.001). Most patients exhibited improvements postoperatively in terms of the systolic thickening of the posterior and superior free walls of the left ventricle. In those in whom the events could be monitored, life-threatening arrhythmias posed complications in three of four patients with ischemic heart disease, and in two of six patients suffering from idiopathic dilated cardiomyopathy. In one patient, death was associated with a transmural alignment of fibrous tissue. CONCLUSIONS: Our measured reductions in myocardial mesh tension were in keeping with the anticipated theoretical reduction in wall stress expected from partial ventriculectomy. The basic concept underscoring surgical maneuvers to reduce ventricular radius, therefore, is sound. A potential trap is the resection of the marginal artery. Critical myofibrosis was a rare complication. Arrhythmias, which are common, can successfully be treated by implantation of antitachycardic and defibrillatory devices. |
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Authors:
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P P Lunkenheimer; K Redmann; D Kimaun; C W Cryer; F Wübbeling; W Konertz; A Zytowsky; H Hotz; S Y Ho; R H Anderson |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 18 ISSN: 0886-0440 ISO Abbreviation: J Card Surg Publication Date: 2003 May-Jun |
Date Detail:
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Created Date: 2003-06-17 Completed Date: 2003-09-26 Revised Date: 2007-11-15 |
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: 225-35 Citation Subset: IM |
Affiliation:
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Klinik und Poliklinik für Thorax, Herz und Gefèasschirurgie, University Münster, Germany. redmann@uni-muenster.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Surgical Procedures / adverse effects, methods* Cardiomyopathy, Dilated / diagnosis, surgery* Cohort Studies Female Follow-Up Studies Heart Function Tests Hemodynamics / physiology Humans Male Middle Aged Postoperative Complications / mortality Probability Risk Assessment Sampling Studies Severity of Illness Index Statistics, Nonparametric Survival Rate Treatment Outcome Ventricular Dysfunction, Left / diagnosis, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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