Surgical treatment of postinfarction anterior left ventricular aneurysms: linear vs. patch plasty repair
a V. Vakhidov Research Centre of Surgery, Tashkent, Uzbekistan b Department of Thoracic and Cardiovascular Surgery, CHU Arnaud de Villeneuve Hospital, 371, avenue du Doyen G. Giraud, 34295 Montpellier Cedex, France *Corresponding author. Tel.: +33-4-67-33-62-72; fax: +33-4-67-33-62-75. E-mail addres...
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description | a V. Vakhidov Research Centre of Surgery, Tashkent, Uzbekistan
b Department of Thoracic and Cardiovascular Surgery, CHU Arnaud de Villeneuve Hospital, 371, avenue du Doyen G. Giraud, 34295 Montpellier Cedex, France
*Corresponding author. Tel.: +33-4-67-33-62-72; fax: +33-4-67-33-62-75. E-mail address : jm-frapier{at}chu-montpellier.fr (J.-M. Frapier).
Background: The patch plasty repair is increasingly advocated over linear closure in the surgical treatment of postinfarction anterior left ventricular aneurysm (LVA). A comparative estimate of the clinical results of these two techniques seemed in order. Methods: Between 1985 and 2004, 53 patients (mean age of 64.2±8.3 years) underwent repair of anterior LVA. Twenty-seven patients underwent linear repair (group 1) and 26 patients patch plasty (group 2). The mean left ventricular ejection fraction was 33.9±8.2% in group 1 vs. 29.7±10.2% in group 2 ( P =0.118). Preoperatively 85.2% of patients in group 1 were in NYHA functional class III or IV vs. 88.5% in group 2 ( P =0.71). All patients had preoperative recurrent ventricular tachycardia (VT) and non-guided encircling cryoablation for treatment of VT was performed in all patients. Coronary revascularization was performed in 29.6% of patients in group 1 and 42.3% in group 2 ( P =0.398). Results: The overall in-hospital mortality was 1.9% as one patient died of low cardiac output (LCO). LCO was the most frequent early postoperative complication and was observed in 66.7% of patients in group 1 vs. 65.4% in group 2 ( P =1.000). LCO was related to right coronary artery disease on multivariate analysis (odds ratio 6.9, P =0.0097). Mean follow-up was 6.4±4.8 years (range 1 day–17.5 years). Overall survival at 10 years was 65.5% of patients in group 1 vs. 60.6% in group 2 ( P =0.395). At 10 years, 91.5% of patients were free from VT or sudden death in group 1 vs. 81% in group 2 ( P =0.269). At follow-up the patients' functional status improved and among survivors 76.9% in group 1 were in NYHA functional class I–II vs. 62.5% in group 2 ( P =0.432). Deaths from congestive heart failure (CHF) occurred in 38.5% of patients in group 1 vs. 55.6% in group 2 ( P =0.632). On multivariate analysis a preoperative left ventricular end-diastolic pressure above 20 mmHg was a predictor of mortality from CHF (odds ratio 9.6, P =0.038). Conclusions: Our study did not reveal significant differences between linear closure and patch plasty repair in the short- and long-term. The choice |
doi_str_mv | 10.1510/icvts.2007.160093 |
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b Department of Thoracic and Cardiovascular Surgery, CHU Arnaud de Villeneuve Hospital, 371, avenue du Doyen G. Giraud, 34295 Montpellier Cedex, France
*Corresponding author. Tel.: +33-4-67-33-62-72; fax: +33-4-67-33-62-75. E-mail address : jm-frapier{at}chu-montpellier.fr (J.-M. Frapier).
Background: The patch plasty repair is increasingly advocated over linear closure in the surgical treatment of postinfarction anterior left ventricular aneurysm (LVA). A comparative estimate of the clinical results of these two techniques seemed in order. Methods: Between 1985 and 2004, 53 patients (mean age of 64.2±8.3 years) underwent repair of anterior LVA. Twenty-seven patients underwent linear repair (group 1) and 26 patients patch plasty (group 2). The mean left ventricular ejection fraction was 33.9±8.2% in group 1 vs. 29.7±10.2% in group 2 ( P =0.118). Preoperatively 85.2% of patients in group 1 were in NYHA functional class III or IV vs. 88.5% in group 2 ( P =0.71). All patients had preoperative recurrent ventricular tachycardia (VT) and non-guided encircling cryoablation for treatment of VT was performed in all patients. Coronary revascularization was performed in 29.6% of patients in group 1 and 42.3% in group 2 ( P =0.398). Results: The overall in-hospital mortality was 1.9% as one patient died of low cardiac output (LCO). LCO was the most frequent early postoperative complication and was observed in 66.7% of patients in group 1 vs. 65.4% in group 2 ( P =1.000). LCO was related to right coronary artery disease on multivariate analysis (odds ratio 6.9, P =0.0097). Mean follow-up was 6.4±4.8 years (range 1 day–17.5 years). Overall survival at 10 years was 65.5% of patients in group 1 vs. 60.6% in group 2 ( P =0.395). At 10 years, 91.5% of patients were free from VT or sudden death in group 1 vs. 81% in group 2 ( P =0.269). At follow-up the patients' functional status improved and among survivors 76.9% in group 1 were in NYHA functional class I–II vs. 62.5% in group 2 ( P =0.432). Deaths from congestive heart failure (CHF) occurred in 38.5% of patients in group 1 vs. 55.6% in group 2 ( P =0.632). On multivariate analysis a preoperative left ventricular end-diastolic pressure above 20 mmHg was a predictor of mortality from CHF (odds ratio 9.6, P =0.038). Conclusions: Our study did not reveal significant differences between linear closure and patch plasty repair in the short- and long-term. The choice of repair technique should be adapted to each patient's anatomical and physiological characteristics.
Key Words: Postinfarction; Left ventricular aneurysm; Linear repair; Patch plasty; Ventricular tachycardia; Cryoablation</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1510/icvts.2007.160093</identifier><identifier>PMID: 18086691</identifier><language>eng</language><publisher>England: Eur Assoc Cardio Surg</publisher><subject>Aged ; Cardiac Output, Low - etiology ; Cardiac Output, Low - mortality ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - methods ; Cryosurgery ; Female ; Heart Aneurysm - etiology ; Heart Aneurysm - mortality ; Heart Aneurysm - physiopathology ; Heart Aneurysm - surgery ; Heart Failure - etiology ; Heart Failure - mortality ; Heart Ventricles - physiopathology ; Heart Ventricles - surgery ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Myocardial Infarction - complications ; Myocardial Infarction - mortality ; Myocardial Infarction - physiopathology ; Myocardial Infarction - surgery ; Odds Ratio ; Recovery of Function ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Stroke Volume ; Suture Techniques ; Tachycardia, Ventricular - etiology ; Tachycardia, Ventricular - mortality ; Tachycardia, Ventricular - physiopathology ; Tachycardia, Ventricular - prevention & control ; Time Factors ; Treatment Outcome ; Ventricular Function, Left</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2008-04, Vol.7 (2), p.256-261</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2883-27badbf937585681923e57396458514b510964418d1568eb1375f49adc5388413</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18086691$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mukaddirov, Mirdavron</creatorcontrib><creatorcontrib>Frapier, Jean-Marc</creatorcontrib><creatorcontrib>Demaria, Rolland Georges</creatorcontrib><creatorcontrib>Albat, Bernard</creatorcontrib><title>Surgical treatment of postinfarction anterior left ventricular aneurysms: linear vs. patch plasty repair</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description>a V. Vakhidov Research Centre of Surgery, Tashkent, Uzbekistan
b Department of Thoracic and Cardiovascular Surgery, CHU Arnaud de Villeneuve Hospital, 371, avenue du Doyen G. Giraud, 34295 Montpellier Cedex, France
*Corresponding author. Tel.: +33-4-67-33-62-72; fax: +33-4-67-33-62-75. E-mail address : jm-frapier{at}chu-montpellier.fr (J.-M. Frapier).
Background: The patch plasty repair is increasingly advocated over linear closure in the surgical treatment of postinfarction anterior left ventricular aneurysm (LVA). A comparative estimate of the clinical results of these two techniques seemed in order. Methods: Between 1985 and 2004, 53 patients (mean age of 64.2±8.3 years) underwent repair of anterior LVA. Twenty-seven patients underwent linear repair (group 1) and 26 patients patch plasty (group 2). The mean left ventricular ejection fraction was 33.9±8.2% in group 1 vs. 29.7±10.2% in group 2 ( P =0.118). Preoperatively 85.2% of patients in group 1 were in NYHA functional class III or IV vs. 88.5% in group 2 ( P =0.71). All patients had preoperative recurrent ventricular tachycardia (VT) and non-guided encircling cryoablation for treatment of VT was performed in all patients. Coronary revascularization was performed in 29.6% of patients in group 1 and 42.3% in group 2 ( P =0.398). Results: The overall in-hospital mortality was 1.9% as one patient died of low cardiac output (LCO). LCO was the most frequent early postoperative complication and was observed in 66.7% of patients in group 1 vs. 65.4% in group 2 ( P =1.000). LCO was related to right coronary artery disease on multivariate analysis (odds ratio 6.9, P =0.0097). Mean follow-up was 6.4±4.8 years (range 1 day–17.5 years). Overall survival at 10 years was 65.5% of patients in group 1 vs. 60.6% in group 2 ( P =0.395). At 10 years, 91.5% of patients were free from VT or sudden death in group 1 vs. 81% in group 2 ( P =0.269). At follow-up the patients' functional status improved and among survivors 76.9% in group 1 were in NYHA functional class I–II vs. 62.5% in group 2 ( P =0.432). Deaths from congestive heart failure (CHF) occurred in 38.5% of patients in group 1 vs. 55.6% in group 2 ( P =0.632). On multivariate analysis a preoperative left ventricular end-diastolic pressure above 20 mmHg was a predictor of mortality from CHF (odds ratio 9.6, P =0.038). Conclusions: Our study did not reveal significant differences between linear closure and patch plasty repair in the short- and long-term. The choice of repair technique should be adapted to each patient's anatomical and physiological characteristics.
Key Words: Postinfarction; Left ventricular aneurysm; Linear repair; Patch plasty; Ventricular tachycardia; Cryoablation</description><subject>Aged</subject><subject>Cardiac Output, Low - etiology</subject><subject>Cardiac Output, Low - mortality</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Cryosurgery</subject><subject>Female</subject><subject>Heart Aneurysm - etiology</subject><subject>Heart Aneurysm - mortality</subject><subject>Heart Aneurysm - physiopathology</subject><subject>Heart Aneurysm - surgery</subject><subject>Heart Failure - etiology</subject><subject>Heart Failure - mortality</subject><subject>Heart Ventricles - physiopathology</subject><subject>Heart Ventricles - surgery</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - surgery</subject><subject>Odds Ratio</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Stroke Volume</subject><subject>Suture Techniques</subject><subject>Tachycardia, Ventricular - etiology</subject><subject>Tachycardia, Ventricular - mortality</subject><subject>Tachycardia, Ventricular - physiopathology</subject><subject>Tachycardia, Ventricular - prevention & control</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventricular Function, Left</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1PwyAYx4nRuDn9AF4MJ2-tUEoL3sziW7LEg3omlNIVQ18EOrNvL3OLO_EAv-cPzw-Aa4xSTDG6M2oTfJohVKa4QIiTEzDHtOAJzxg9_a85mYEL778QwhwRdA5mmCFWFBzPQfs-ubVR0sLgtAyd7gMcGjgOPpi-kU4FM_RQ9kE7MzhodRPgJkLOqMlKF2_05La-8_fQml7Hk41P4SiDauFopQ9b6PQojbsEZ420Xl8d1gX4fHr8WL4kq7fn1-XDKlEZYyTJykrWVcNJSRktGOYZ0bQkvMjjHudVHDvWOWZ1HI7pCkewybmsFSWM5ZgswO0-d3TD96R9EJ3xSlsbfzpMXpQop1FPHkG8B5UbvHe6EaMznXRbgZHY6RV_esVOr9jrjT03h_Cp6nR97Dj4PL7emnX7Y5wWvpPWRjzbx5UiExktyC8Eu4U2</recordid><startdate>200804</startdate><enddate>200804</enddate><creator>Mukaddirov, Mirdavron</creator><creator>Frapier, Jean-Marc</creator><creator>Demaria, Rolland Georges</creator><creator>Albat, Bernard</creator><general>Eur Assoc Cardio Surg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200804</creationdate><title>Surgical treatment of postinfarction anterior left ventricular aneurysms: linear vs. patch plasty repair</title><author>Mukaddirov, Mirdavron ; Frapier, Jean-Marc ; Demaria, Rolland Georges ; Albat, Bernard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2883-27badbf937585681923e57396458514b510964418d1568eb1375f49adc5388413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Cardiac Output, Low - etiology</topic><topic>Cardiac Output, Low - mortality</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Cryosurgery</topic><topic>Female</topic><topic>Heart Aneurysm - etiology</topic><topic>Heart Aneurysm - mortality</topic><topic>Heart Aneurysm - physiopathology</topic><topic>Heart Aneurysm - surgery</topic><topic>Heart Failure - etiology</topic><topic>Heart Failure - mortality</topic><topic>Heart Ventricles - physiopathology</topic><topic>Heart Ventricles - surgery</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - surgery</topic><topic>Odds Ratio</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Stroke Volume</topic><topic>Suture Techniques</topic><topic>Tachycardia, Ventricular - etiology</topic><topic>Tachycardia, Ventricular - mortality</topic><topic>Tachycardia, Ventricular - physiopathology</topic><topic>Tachycardia, Ventricular - prevention & control</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mukaddirov, Mirdavron</creatorcontrib><creatorcontrib>Frapier, Jean-Marc</creatorcontrib><creatorcontrib>Demaria, Rolland Georges</creatorcontrib><creatorcontrib>Albat, Bernard</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mukaddirov, Mirdavron</au><au>Frapier, Jean-Marc</au><au>Demaria, Rolland Georges</au><au>Albat, Bernard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical treatment of postinfarction anterior left ventricular aneurysms: linear vs. patch plasty repair</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2008-04</date><risdate>2008</risdate><volume>7</volume><issue>2</issue><spage>256</spage><epage>261</epage><pages>256-261</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>a V. Vakhidov Research Centre of Surgery, Tashkent, Uzbekistan
b Department of Thoracic and Cardiovascular Surgery, CHU Arnaud de Villeneuve Hospital, 371, avenue du Doyen G. Giraud, 34295 Montpellier Cedex, France
*Corresponding author. Tel.: +33-4-67-33-62-72; fax: +33-4-67-33-62-75. E-mail address : jm-frapier{at}chu-montpellier.fr (J.-M. Frapier).
Background: The patch plasty repair is increasingly advocated over linear closure in the surgical treatment of postinfarction anterior left ventricular aneurysm (LVA). A comparative estimate of the clinical results of these two techniques seemed in order. Methods: Between 1985 and 2004, 53 patients (mean age of 64.2±8.3 years) underwent repair of anterior LVA. Twenty-seven patients underwent linear repair (group 1) and 26 patients patch plasty (group 2). The mean left ventricular ejection fraction was 33.9±8.2% in group 1 vs. 29.7±10.2% in group 2 ( P =0.118). Preoperatively 85.2% of patients in group 1 were in NYHA functional class III or IV vs. 88.5% in group 2 ( P =0.71). All patients had preoperative recurrent ventricular tachycardia (VT) and non-guided encircling cryoablation for treatment of VT was performed in all patients. Coronary revascularization was performed in 29.6% of patients in group 1 and 42.3% in group 2 ( P =0.398). Results: The overall in-hospital mortality was 1.9% as one patient died of low cardiac output (LCO). LCO was the most frequent early postoperative complication and was observed in 66.7% of patients in group 1 vs. 65.4% in group 2 ( P =1.000). LCO was related to right coronary artery disease on multivariate analysis (odds ratio 6.9, P =0.0097). Mean follow-up was 6.4±4.8 years (range 1 day–17.5 years). Overall survival at 10 years was 65.5% of patients in group 1 vs. 60.6% in group 2 ( P =0.395). At 10 years, 91.5% of patients were free from VT or sudden death in group 1 vs. 81% in group 2 ( P =0.269). At follow-up the patients' functional status improved and among survivors 76.9% in group 1 were in NYHA functional class I–II vs. 62.5% in group 2 ( P =0.432). Deaths from congestive heart failure (CHF) occurred in 38.5% of patients in group 1 vs. 55.6% in group 2 ( P =0.632). On multivariate analysis a preoperative left ventricular end-diastolic pressure above 20 mmHg was a predictor of mortality from CHF (odds ratio 9.6, P =0.038). Conclusions: Our study did not reveal significant differences between linear closure and patch plasty repair in the short- and long-term. The choice of repair technique should be adapted to each patient's anatomical and physiological characteristics.
Key Words: Postinfarction; Left ventricular aneurysm; Linear repair; Patch plasty; Ventricular tachycardia; Cryoablation</abstract><cop>England</cop><pub>Eur Assoc Cardio Surg</pub><pmid>18086691</pmid><doi>10.1510/icvts.2007.160093</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Cardiac Output, Low - etiology Cardiac Output, Low - mortality Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - methods Cryosurgery Female Heart Aneurysm - etiology Heart Aneurysm - mortality Heart Aneurysm - physiopathology Heart Aneurysm - surgery Heart Failure - etiology Heart Failure - mortality Heart Ventricles - physiopathology Heart Ventricles - surgery Humans Kaplan-Meier Estimate Male Middle Aged Myocardial Infarction - complications Myocardial Infarction - mortality Myocardial Infarction - physiopathology Myocardial Infarction - surgery Odds Ratio Recovery of Function Retrospective Studies Risk Assessment Severity of Illness Index Stroke Volume Suture Techniques Tachycardia, Ventricular - etiology Tachycardia, Ventricular - mortality Tachycardia, Ventricular - physiopathology Tachycardia, Ventricular - prevention & control Time Factors Treatment Outcome Ventricular Function, Left |
title | Surgical treatment of postinfarction anterior left ventricular aneurysms: linear vs. patch plasty repair |
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