Document Detail


The role of left ventricular reconstruction for cardiogenic shock.
MedLine Citation:
PMID:  11807743     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Left ventricular remodeling after myocardial infarction is recognized as an early adaptive mechanism that later results in adverse physiologic changes. Surgical therapy for this condition includes exclusion of nonfunctional segments of ventricular wall and restoration of more normal ventricular geometry. The Dor procedure, or endoventricular patch plasty, is recognized as an excellent means of accomplishing this goal. Most series in regard to the Dor procedure report results in patients who electively come to surgery after developing global ventricular distension after an area of akinesia or dyskinesia. We report a small series of 6 patients who presented with acute myocardial infarction and who developed cardiogenic shock after ventricular dilation. Each patient underwent emergent revascularization and left ventricular reconstruction using the Dor technique. A seventh patient with akenesia, but without preoperative shock, required the Dor procedure to wean from cardiopulmonary bypass. There were no in-hospital deaths, and follow-up showed good outcomes. In certain select acute subsets (large anterior myocardial infarction, cardiogenic shock, and ventricular dilation), immediate revascularization and restoration of left ventricular size improves outcomes by changing left ventricular shape and thereby pre-empting remodeling and restoring blood flow to ischemic myocardium.
Authors:
P E Parrino; I L Kron;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in thoracic and cardiovascular surgery     Volume:  13     ISSN:  1043-0679     ISO Abbreviation:  Semin. Thorac. Cardiovasc. Surg.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2002-01-24     Completed Date:  2002-03-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8917640     Medline TA:  Semin Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  476-9     Citation Subset:  IM    
Copyright Information:
Copyright 2001 by W.B. Saunders Company
Affiliation:
Division of Thoracic Cardiovascular Surgery, Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, VA, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass
Coronary Stenosis / complications,  mortality,  surgery
Female
Follow-Up Studies
Heart Ventricles / surgery*
Humans
Male
Myocardial Infarction / complications,  mortality,  surgery
Reconstructive Surgical Procedures*
Shock, Cardiogenic / etiology*,  mortality,  surgery*
Stroke Volume / physiology
Survival Analysis
Treatment Outcome
Virginia

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


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