Relation of aneurysmectomy in patients with advanced left ventricular remodeling to postoperative left ventricular filling pressure, redilatation with ischemic mitral regurgitation.
Left ventricular (LV) volume, mitral E deceleration time, and mitral regurgitation (MR) fraction were measured by echocardiography in 14 patients with surgical LV aneurysmectomy. Late MR developed 3 to 6 months after surgery in 5 of the 14 patients (36%). Compared with patients without late MR, those with late MR had a significantly greater preoperative LV end-diastolic volume index (LVEDVI) (134 +/- 21 vs 93 +/- 19 ml/m(2), p <0.01), surgical reduction in LVEDVI (-51 +/- 14 vs -20 +/- 16 ml/m(2), p <0.01), early postoperative LV diastolic dysfunction with shortened mitral E deceleration time (106 +/- 23 vs 141 +/- 24 ms, p <0.01), and a late postoperative reincrease in LVEDVI (+28 +/- 4 vs +3 +/- 8 ml/m(2), p <0.01), suggesting that surgical LV aneurysmectomy in patients with advanced preoperative LV remodeling may result in postoperative LV diastolic dysfunction, promoting later LV redilation with ischemic MR.
Otsuji
Yutaka
Y
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Japan. yutaka@m.kufm.kagoshima-u.ac.jp
Kuwahara
Eiji
E
Yuge
Keiko
K
Yotsumoto
Goichi
G
Ueno
Takayuki
T
Nakashiki
Kenichi
K
Hamasaki
Shuichi
S
Biro
Sadatoshi
S
Minagoe
Shinichi
S
Levine
Robert A
RA
Sakata
Ryuzo
R
Tei
Chuwa
C
D000368:Aged; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000503:physiopathology; D001026:Coronary Artery Bypass; D015150:Echocardiography, Doppler; D006322:Heart Aneurysm / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*; D010210:Papillary Muscles / Q000000981:diagnostic imaging / Q000503:physiopathology; D011183:Postoperative Complications; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D020257:Ventricular Remodeling / Q000502:physiology*