title: Relation of aneurysmectomy in patients with advanced left ventricular remodeling to postoperative left ventricular filling pressure, redilatation with ischemic mitral regurgitation.
abstract: 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.
authors.affiliation: Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Japan. yutaka@m.kufm.kagoshima-u.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otsuji
authors.forename: Eiji
authors.initials: E
authors.lastname: Kuwahara
authors.forename: Keiko
authors.initials: K
authors.lastname: Yuge
authors.forename: Goichi
authors.initials: G
authors.lastname: Yotsumoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ueno
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nakashiki
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hamasaki
authors.forename: Sadatoshi
authors.initials: S
authors.lastname: Biro
authors.forename: Shinichi
authors.initials: S
authors.lastname: Minagoe
authors.forename: Robert A
authors.initials: RA
authors.lastname: Levine
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Sakata
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: 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*