title: Left ventricular reconstruction with no-patch technique: early and late clinical outcomes.
abstract: BACKGROUND
  Few studies have evaluated late clinical outcome of no-patch technique in patients with large left ventricular aneurysms. The objectives of this study were to evaluate a no-patch surgical technique to reconstruct the left ventricle in patients with left ventricular aneurysm and to assess early and late clinical outcomes.
  
  
  METHODS
  In 1995, we began using a no-patch technique in patients with dyskinetic left ventricular aneurysms. A total of 145 patients underwent left ventricular reconstruction with this technique and were followed up for (59 ± 29) months (range, 1 - 127 months). Risk factors for early mortality were analyzed by bivariate analyses. Cox's proportional hazards model was used to calculate risk factors for all-cause mortality and hospital readmission. Kaplan-Meier methodology was used to analyze late survival.
  
  
  RESULTS
  One week after operation, left ventricular end-diastolic diameter had decreased from (61 ± 8) mm to (55 ± 8) mm, and geometry of the left ventricle was restored to a more normal conical shape. Early mortality was 3% and late mortality 11%. Over a 5-year follow-up period, hospital readmission was 28%. One-, 5-, and 10-year survival estimates were 95% (95% confidence interval (CI) 91% - 99%), 86% (95%CI 78% - 94%), and 74% (95%CI 60% - 88%). Readmission-free survival at 1 and 5 years after operation was 87% (95%CI 81% - 93%) and 60% (95%CI 50% - 70%), respectively.
  
  
  CONCLUSIONS
  The no-patch technique for left ventricular reconstruction is an effective and simple procedure that can achieve satisfactory early and late clinical outcomes in patients with left ventricular aneurysms.
authors.affiliation: Department of Cardiovascular Surgery, Research Center for Cardiovascular Regenerative Medicine, Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China. shengshouhu@yahoo.com
authors.forename: Sheng-Shou
authors.initials: SS
authors.lastname: Hu
authors.forename: Hong-Guang
authors.initials: HG
authors.lastname: Fan
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zheng
authors.forename: Wei
authors.initials: W
authors.lastname: Feng
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Yun-Hu
authors.initials: YH
authors.lastname: Song
authors.forename: Li-Qing
authors.initials: LQ
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Yuan
authors.forename: Shi-Ju
authors.initials: SJ
authors.lastname: Zhang
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006322:Heart Aneurysm / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome