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Late results of endoventricular patch plasty repair in akinetic and dysknetic areas after acute myocardial infaction

By Paulo Roberto Lunardi Prates, Abud Homsi-Neto, Lucas Maynard Lovato, Guaracy F. Teixeira Filho, João Ricardo Michielin Sant'Anna, Luis Maria Yordi, Renato Abdala Karam Kalil and Ivo Abrahao Nesralla


Objective - To assess the surgical results of endoventricular patch plasty repair in akinetic and dyskinetic left ventricular areas. Methods - 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. Results - 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. Conclusion - 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

Topics: Ventricular aneurysm, Aneurisma cardíaco, Disfunção ventricular, Ventricular dysfunction, Cirurgia torácica, Cardiac surgery, Hemodynamic assessment
Year: 2010
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