[Cardiac function following left ventricular aneurysm repair--comparison between patch reconstruction and direct closure methods].
Left ventricular function was compared between two groups of patients who underwent patch reconstruction or direct closure of the ventricular wall following resection of a post-infarction left ventricular aneurysm (LVA). There were 15 and 9 patients in the respective groups. Coronary artery bypass grafting was additionally performed in 8 patients (53%) in the patch reconstruction group and 5 patients (56%) in the direct closure group. The size of the patch used for patch reconstruction (including the suture line) was 57 +/- 19% of the resected area. Before and 1-2 months after surgery, equilibrium RI angiography and cardiac catheterization were performed to assess the following hemodynamic parameters: ejection fraction (EF) at rest and during exercise, left ventricular end-diastolic pressure (LVEDP), left ventricular end-diastolic volume index (LVEDVI), cardiac index (CI) and mean pulmonary artery pressure (m-PAP). Preoperatively, there were no differences in each parameter between the two groups. Postoperatively, there were significant improvements in the EF at rest and during exercise (p < 0.01), LVEDVI (p < 0.01) and the LVEDP (p < 0.05). However there no significant changes in CI or m-PAP following the operation. There were also no significant differences observed in the postoperative values between the two groups. However, based upon postoperative left ventriculograms, patch reconstruction was significantly superior to direct closure for reconstruction of a septal aneurysm.
Kawata
T
T
Department of Surgery III, Nara Medical College, Kashihara, Japan.
Kitamura
S
S
Kawachi
K
K
Morita
R
R
Seki
T
T
Taniguchi
S
S
Fukutomi
M
M
Hasegawa
J
J
Kameda
Y
Y
Kondo
Y
Y
D000368:Aged; D001807:Blood Vessel Prosthesis; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D015718:Fibrin Tissue Adhesive; D006322:Heart Aneurysm / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D011093:Polyethylene Terephthalates; D016277:Ventricular Function, Left
D015718:Fibrin Tissue Adhesive; D011093:Polyethylene Terephthalates