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  • 1
    Electronic Resource
    Electronic Resource
    Surgical Treatment of Post Infarction Left Ventricular Aneurysms: Our Experience with Double Breasting and Dor's Repair (2003)
    350 Main Street , Malden , MA 02148 , USA. , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiac surgery 18 (2003), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Background: This is a retrospective study of left ventricle (LV) aneurysm repair done at the Escorts Heart Institute and Research Centre, New Delhi, since October 1988. Two methods of LV aneurysm repair are practiced: double breasting (DB) and Dor's repair. The method varies with location, size, and extent of aneurysm and quality of the fibrotic wall of the aneurysm. Methods: Between October 1988 and May 2001, 129 patients underwent LV aneurysm repair using one of the two techniques; 78 patients had Dor's repair while 51 patients had DB repair. Results: Overall mortality was 2.3% (three patients). One patient died in the DB group, and two patients died in the Dor's repair group. Mean preoperative ejection fraction (EF) after surgery in DB was 31% while in Dor's repair it was 29.2%. EF showed improvement after surgery to 48.5% in DB and 46.6% in Dor's repair. Decrease in end-diastolic volume (EDV) in DB was from 146 to91.4 cm3/m2, and in Dor's repair it was from156 cm3/m2to88.6 cm3/m2.Decrease in end-systolic volume was from101 cm3/m2to60.2 cm3/m2in DB and from109 cm3/m2to64.5 cm3/m2in Dor's group. All of these values showed statistically significant improvement. At six months postoperatively, 83 patients (74.1%) out of 112 patients who were preoperatively in New York Heart Association (NYHA) Functional Classes III and IV improved to class II while 7 patients (6.3%) improved to class I. Conclusion: In our experience Dor's repair is indicated for anteroseptal and apical isolated posterior aneurysm to restore LV volume and geometry while DB is indicated for apical, anterolateral, and lateral aneurysms where septal involvement is less. These two techniques have definite indications and advantages with good results.(J Card Surg 2003;18:114-120)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8191.2003.02010.x
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  • 2
    Electronic Resource
    Electronic Resource
    Predictors of Early Outcome After Coronary Artery Surgery in Patients with Severe Left Ventricular Dysfunction (2003)
    350 Main Street , Malden , MA 02148 , USA. , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiac surgery 18 (2003), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Background: The surgical survival in patients with severe myocardial dysfunction is critically dependent on the selection of patients. The present study was undertaken to identify the prognostic factors in such patients. Methods: We analyzed the data of 176 consecutive patients (161 men, 15 women), aged 29 to 88 years (mean 58.43), with a left ventricular ejection fraction (LVEF) 〈30% who underwent isolated coronary artery bypass grafting. The LVEF ranged from 15% to 30% (mean 27.18%). Preoperatively, 33% had angina, 19.9% had recent myocardial infarction, and 21.6% had congestive heart failure. The mean number of grafts was 2.5/patient. The intra-aortic balloon was used prophylactically in 20.5% of patients and therapeutically in 4.0% of patients. Results: The hospital mortality was 2.3%. The complications occurred as follows: perioperative myocardial infarction in two (1.1%), intractable ventricular arrhythmias in two (1.1%), prolonged ventilation in four (2.3%) and peritoneal dialysis in 1 (0.6%). The mean ICU and hospital stay were2.46 ± 0.76and7.57 ± 2.24days, respectively. The predictors of survival on univariate analysis were New York Heart Association (NYHA) class(x2 = 14.458, p 〈 0.001), recent myocardial infarction(x2 = 5.852, p = 0.016), congestive heart failure (CHF)(x2 = 5.526, p = 0.019), and left ventricular end-systolic volume index (LVESVI)(x2 = 25.833, p 〈 0.001). However, on multivariate analysis, left ventricular end-systolic volume index was the only independent left ventricular function measurement predictive of survival(x2 = 10.228, p = 0.001). Conclusion: Left ventricular end-systolic volume index is the most important predictor of survival after coronary artery bypass surgery in patients with severe myocardial dysfunction.(J Card Surg 2003;18:101-106)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8191.2003.02011.x
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    Paper (German National Licenses)
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