[Sudden arythmogenic death in hospitals after heart surgery].
29 cases of sudden heart death (SHD) which occurred in hospital after heart surgery within 1989-1998 are reported. More than 50% were SHD after aortocoronary shunting, it occurred in stenosing atherosclerosis of more than 3 arteries. An important role in tanatogenesis belongs to ischemic heart disease (IHD) with complications (chronic aneurysm of the left ventricle, postinfarction failure of the mitral valve) and combination of IHD with aortal heart deficiency which is followed by pronounced hypertrophy of the left ventricle which is an important factor of SHD risk. Interventricular defects and Fallot's tetrad are most frequent among heart malformations with SHD after heart surgery. Cardiomegaly, myocardial fibrosis, dilatation of the heart cavities, fibroelastosis of ventricular endocardium, anomalous chordal arrangement in the left ventricle, right ventricular lipomatosis are main factors of SHD of the arrhythmogenic type after heart surgery. Introduction of the new notion "sudden heart death at the hospital stage after heart surgery" is suggested.
Bokeriia
L A
LA
A. N. Bakulev Research Center for Cardiovascular Surgery, 121522, Moscow.
Serov
R A
RA
Mozhina
A A
AA
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000473:pathology; D006348:Cardiac Surgical Procedures; D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011183:Postoperative Complications / Q000473:pathology*; D011184:Postoperative Period