Late results of endoventricular patch plasty repair in akinetic and dyskinetic areas after acute myocardial infarction.
To assess the surgical results of endoventricular patch plasty repair in akinetic and dyskinetic left ventricular areas.



We studied 52 patients who had undergone endoventricular patch plasty repair associated with myocardial revascularization. The preoperative functional class distribution was as follows: class I in 1 (1.9%) patient; class II in 2 (3.8%) patients; class III in 23 (44.2%) patients; and class IV in 26 (50%) patients.



The immediate mortality rate was 7.6% (4 patients). The clinical outcome of 44 patients followed up within a mean postoperative time of 29+/-25 months was as follows: class I in 33 (75%) patients; class II in 7 (15.9%) patients; class III in 2 (4.5%) patients; and class IV in 2 (4.5%) patients. Comparison between pre- and postoperative catheterization in 21 patients showed that the ejection fraction increased from 46.3% to 51.3% (p=0.17); the left ventricular systolic volume decreased from 76.4 mL to 57.5 mL, (p=0.078); and the left ventricular diastolic volume decreased from 141.2 mL to 105.8 mL (p=0.0 73). These findings showed the tendency toward improvement, but with nonsignificant results.



The technique proved to be effective, to have a low mortality rate, to cause significant clinical improvement, an increase in ejection fraction, and a reduction in left ventricular volumes.
Prates
Paulo R
PR
Instituto de Cardiologia do Rio Grande so Sul, Universitaria de Cardiologia, Porte Alegre, RS, Brazil. pesquisa@cardnet.tche.br
Homsi Neto
Abud
A
Lovato
Lucas Maynard
LM
Teiseira
Guaracy F
GF
Sant'Anna
João R M
JR
Yordi
Luiz M
LM
Kalil
Renato A K
RA
Nesralla
Ivo A
IA
D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006322:Heart Aneurysm / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D009204:Myocardial Revascularization; D011184:Postoperative Period; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000601:surgery*