71 research outputs found
A Bovine Pericardium Rigid Prosthesis For Left Ventricle Restoration: 12 Years Of Follow-up [prótese Rígida De Pericárdio Bovino Para Remodelamento Ventricular Esquerdo: 12 Anos De Seguimento]
Background: Myocardial infarction might result in dilated left ventricle and numerous techniques have been described to restore the original left ventricle shape and identify tools for late survival assessment. The aim of this study is to compare our experience with a modified Dor procedure using a rigid prosthesis to the septal anterior ventricular exclusion procedure (SAVE) for left ventricle restoration. The EuroScore index for prediction of late follow up survival was evaluated. Methods: We evaluated 80 patients who underwent left ventricle restoration between 1999 to 2007 and eight patients were excluded with incomplete data. A modified Dor procedure with rigid prosthesis (MD group) was performed on 53 patients and 19 underwent the septal anterior ventricular exclusion procedure (SAVE group). The patients were classified according their left ventricle shape as type I, II or III. Kaplan-Meier and Cox proportional hazard ratio regressions analysis were performed to assess survival after both techniques and expected surgical mortality using EuroScore index ranking after 12 years of follow up. Results: The operative mortality was comparable in both groups ranked by EuroScore index. The groups were comparable for all clinical data, except the MD group had more patients using intra-aortic balloon pumps before surgery, (5.7% vs. 0; P<0.01). Kaplan Meier analysis by left ventricle shape showed comparable survival for all patients, with slightly higher survival for type I. Kaplan Meier analysis of all death showed equivalent survival curves for both techniques after 12 years of follow up (71.5 ± 12.3 vs. 46.6 ±20.5 years; P=0.08). Kaplan Meier analysis of EuroScore index for all patients showed a difference between the three ranked categories, i.e., 0 to 10%, 11 to 49% and higher than 50% expected surgical mortality after 12 years of follow up (70.9 ± 16.2 vs. 67.5 ± 12.7 vs. 53.0 ± 15.5; P=0.003). Conclusion: The MD procedure showed consistent ejection fraction improvements after long term follow up. Survival was comparable for all ventricular types and for the MD and SAVE procedures. The EuroScore index is a useful index for late survival assessment of ventricular restoration techniques.262164172Cooley, D.A., Hallman, G.L., Henly, W.S., Left ventricular aneurysm due to myocardial infarctionexperience with 37 patients undergoing aneurysmectomy (1964) Arch Surg, 88, pp. 114-121Jatene, A.D., Left ventricular aneurysmectomy. Resection or reconstruction (1985) J Thorac Cardiovasc Surg, 89 (3), pp. 321-331Dor, V., Saab, M., Coste, P., Kornaszewska, M., Montiglio, F., Left ventricular aneurysm: A new surgical approach (1989) Thorac Cardiovasc Surg, 37 (1), pp. 11-19Dor, V., Sabatier, M., di Donato, M., Montiglio, F., Toso, A., Maioli, M., Efficacy of endoventricular patch plasty in large postinfarction akinetic scar and severe left ventricular dysfunction: Comparison with a series of large dyskinetic scars (1998) J Thorac Cardiovasc Surg, 116 (1), pp. 50-59Braile, D.M., Mustafa, R.M., Ardito, R.V., Zaiantchick, M., Coelho, W.M., (1991) Correction of the Left Ventricle Geometry with Semi Rigid Bovine Pericardial Prosthesis Rev Bras Cir Cardiovasc, 6 (2), pp. 109-115Isomura, T., Horii, T., Suma, H., Buckberg, G.D., Septal anterior ventricular exclusion operation (Pacopexy) for ischemic dilated cardiomyopathy: Treat form not disease (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S245-S250. , RESTORE GroupJones, R.H., Velazquez, E.J., Michler, R.E., Sopko, G., Oh, J.K., O'Connor, C.M., Coronary bypass surgery with or without surgical ventricular reconstruction (2009) N Engl J Med, 360 (17), pp. 1705-1717di Donato, M., Castelvecchio, S., Kukulski, T., Bussadori, C., Giacomazzi, F., Frigiola, A., Surgical ventricular restoration: Left ventricular shape influence on cardiac function, clinical status, and survival (2009) Ann Thorac Surg, 87 (2), pp. 455-461Najafi, M., Sheikhvatan, M., Montazeri, A., Sheikhfathollahi, M., Predictors of quality of life among patients undergoing coronary artery bypass surgery (2008) Acta Cardiol, 63 (6), pp. 713-721Messaoudi, N., de Cocker, J., Stockman, B.A., Bossaert, L.L., Rodrigus, I.E., Is EuroSCORE useful in the prediction of extended intensive care unit stay after cardiac surgery? (2009) Eur J Cardiothorac Surg, 36 (1), pp. 35-39Santarpino, G., Onorati, F., Rubino, A.S., Abdalla, K., Caroleo, S., Santangelo, E., Preoperative intraaortic balloon pumping improves outcomes for high-risk patients in routine coronary artery bypass graft surgery (2009) Ann Thorac Surg, 87 (2), pp. 481-488Nashef, S.A., Roques, F., Michel, P., Gauducheau, E., Lemeshow, S., Salamon, R., European system for cardiac operative risk evaluation (EuroSCORE) (1999) Eur J Cardiothorac Surg, 16 (1), pp. 9-13Dor, V., Sabatier, M., di Donato, M., Maioli, M., Toso, A., Montiglio, F., Late hemodynamic results after left ventricular patch repair associated with coronary grafting in patients with postinfarction akinetic or dyskinetic aneurysm of the left ventricle (1995) J Thorac Cardiovasc Surg, 110 (5), pp. 1291-1299Athanasuleas, C.L., Buckberg, G.D., Stanley, A.W., Siler, W., Dor, V., Didonato, M., RESTORE Group. Surgical ventricular restoration: The RESTORE Group experience (2004) Heart Fail Rev, 9 (4), pp. 287-297Salati, M., di Biasi, P., Paje, A., Santoli, C., Left ventricular geometry after endoventriculoplasty (1993) Eur J Cardiothorac Surg, 7 (11), pp. 574-578Buckberg, G.D., Coghlan, H.C., Torrent-Guasp, F., The structure and function of the helical heart and its buttress wrapping. VI. Geometric Concepts of Heart Failure and Use For Structural Correction (2001) Semin Thorac Cardiovasc Surg, 13 (4), pp. 386-401di Donato, M., Sabatier, M., Dor, V., Gensini, G.F., Toso, A., Maioli, M., Effects of the Dor procedure on left ventricular dimension and shape and geometric correlates of mitral regurgitation one year after surgery (2001) J Thorac Cardiovasc Surg, 121 (1), pp. 91-96Suma, H., Horii, T., Isomura, T., Buckberg, G., A new concept of ventricular restoration for nonischemic dilated cardiomyopathy (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S207-S212. , RESTORE GroupForm versus disease: Optimizing geometry during ventricular restoration (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S238-S244. , RESTORE GroupKieser, T.M., The left ventricle: To reconstruct or not: Lessons from the STICH trial (2009) J Thorac Cardiovasc Surg, 138 (3), p. 784Suma, H., Isomura, T., Horii, T., Buckberg, G., Role of site selection for left ventriculoplasty to treat idiopathic dilated cardiomyopathy (2004) Heart Fail Rev, 9 (4), pp. 329-336. , RESTORE GroupDancini, J.L., Rodrigues, J.J., Santos, J.S., Pinto, R.F.A., Burgos, F.J.C., Conforti, C.A., Left ventricular aneurysmectomy: Late followup (1996) Rev Bras Cir Cardiovasc, 1 (11), pp. 23-29Almeida, R.M.S., Lima, J.D., Bastos, L.C., Carvalho, C.T., Loures, D.R., Endoventricular circular patch plasty with septal exclusion: Initial experience (2000) Rev Bras Cir Cardiovasc, 4 (15), pp. 302-307Campagnucci, V.P., Rivetti, L.A., Pinto e Silva, A.M.R., Gandra, S.M.A., Pereira, W.L., Aneurismectomia de ventrículo esquerdo com o coração batendo ininterruptamente: Resultados imediatos (2006) Rev Bras Cir Cardiovasc, 21 (1), pp. 55-61Herrera, C.B., Insalralde, A., Brandi, A.C., Santos, C.A., Herrera, D.D., Soares, M.J.F., Correção de aneurisma de ventrículo esquerdo em paciente chagásico empregando prótese de pericárdio bovino (2000) Rev Bras Cir Cardiovasc, 15 (1), pp. 72-74Sgarbi, C.J., Ardito, R.V., Santos, R.C., Bogdan, R.A.B., Arruda Jr., F.V., Silva, E.M., Correção cirúrgica do aneurisma de ventrículo esquerdo: Comparação entre as técnicas de sutura linear e reconstrução geométrica (2000) Rev Bras Cir Cardiovasc, 15 (4), pp. 293-301Versteegh, M.I., Lamb, H.J., Bax, J.J., Curiel, F.B., van der Wall, E.E., de Roos, A., MRI evaluation of left ventricular function in anterior LV aneurysms before and after surgical resection (2003) Eur J Cardiothorac Surg, 23 (4), pp. 609-613Use of cardiac magnetic resonance imaging in surgical ventricular restoration (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S216-S224. , Buckberg GD;RESTORE GroupWalker, J.C., Guccione, J.M., Jiang, Y., Zhang, P., Wallace, A.W., Hsu, E.W., Helical myofiber orientation after myocardial infarction and left ventricular surgical restoration in sheep (2005) J Thorac Cardiovasc Surg, 129 (2), pp. 382-39
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For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types
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