Abstract:
OBJECTIVES:Treatment of cardiac failure due to non-ischemic cardiomyopathy by left ventriculoplasty using partial left ventriculectomy (Batista operation) or septal anterior ventricular exclusion was evaluated. METHODS:Left ventriculoplasty was performed in 70 patients (59 men and 11 women with a mean age of 51 years) from December 1996 to June 2000. Preoperative New York Heart Association (NYHA) functional class was IV in 43 patients including 29 receiving inotropic support, and class III in 27 patients. Nineteen patients required emergency surgery because of on-going shock and 51 patients were operated electively. Combined cardiac procedures were mitral valve reconstruction in 62 patients (45 replacements, 17 repairs), tricuspid annuloplasty in 37, and aortic valve replacement in 4. The initial 24 patients underwent typical Batista operation regardless of myocardial viability. The other 46 patients underwent selective ventriculoplasty to excise or exclude the weakest part according to the findings of the intraoperative echo-guided volume reduction test. RESULTS:The intraaortic balloon pump was used in 12 patients and the left ventricular assist device in 2 patients. Three (5.9%) of the 51 patients who underwent elective operation and 12 (63.2%) of the 19 patients with emergency operation died in the hospital, giving an overall hospital mortality of 21.4% (15/70). Hospital mortality was reduced from 33.3% (8/24) in the initial 24 patients to 15.2% (7/46) in the recent 46 patients with the volume reduction test. Mean ejection fraction increased from 22.2 +/- 6.7% to 29.6 +/- 6.0%. Diastolic dimension decreased from 81.1 +/- 9.5 to 69.8 +/- 19.2 mm. End-diastolic and systolic volume indices decreased from 199.0 +/- 47.9 to 124.1 +/- 34.9 ml/m2 and from 154.0 +/- 41.2 to 89.3 +/- 31.7 ml/m2, respectively, at one postoperative month in the 55 hospital survivors. The mean pulmonary capillary wedge pressure decreased from 25.6 +/- 7.8 to 13.6 +/- 4.5 mmHg. Serum brain natriuretic peptide decreased from 999 +/- 647 preoperatively to 547 +/- 362 pg/ml one month after the operation. Thirteen patients (18.6%) died in the late period mainly due to heart failure. Among the 42 survivors, 37 patients returned to NYHA functional class I-II, and cardiac events were rare after one postoperative year. Actuarial survivals at 3 years in elective and emergency operations were 71.9% and 33.3%, respectively. CONCLUSIONS:Left ventriculoplasty is acceptably safe for elective operation and clinical improvement can be obtained by proper surgical procedures and careful postoperative medical treatment.
journal_name
J Cardioljournal_title
Journal of cardiologyauthors
Suma H,Isomura T,Horii T,Hisatomi K,Sato T,Kobashi T,Kanemitsu H,Hoshino J,Ueno H,Oda Tsubject
Has Abstractpub_date
2001-01-01 00:00:00pages
1-10issue
1eissn
0914-5087issn
1876-4738journal_volume
37pub_type
杂志文章abstract:BACKGROUND:Due to the lack of nephrotoxic activity, proliferation signal inhibitors (PSI) such as everolimus are recommended for immunosuppression after heart transplantation, but the assessment of renal function in patients receiving PSI has led to conflicting results. We examined renal integrity and function using ne...
journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2014.12.010
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abstract:BACKGROUND AND OBJECTIVES:Intravenous myocardial contrast echocardiography is used clinically, but use in small animals has not been evaluated. The conditions for myocardial opacification and the feasibility of myocardial contrast echocardiography were examined in mice. METHODS:Closed chest mice were examined. The lef...
journal_title:Journal of cardiology
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abstract:OBJECTIVES:To determine which improves clinical outcomes more, sutureless (including rapid-deployment) aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), we performed a meta-analysis of comparative studies. METHODS:MEDLINE and EMBASE were searched through June 2015 using Web-based search...
journal_title:Journal of cardiology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jjcc.2015.09.009
更新日期:2016-06-01 00:00:00
abstract::Both coronary perforation and aneurysms associated with sirolimus-eluting stent (SES) implantations are uncommon complications. We describe an unusual case of a coronary aneurysm associated with a coronary perforation after SES implantation. Although their pathogenesis has not yet been completely elucidated, some tech...
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doi:10.1016/j.jjcc.2008.09.013
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journal_title:Journal of cardiology
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journal_title:Journal of cardiology
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2008.06.002
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
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pub_type: 杂志文章
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journal_title:Journal of cardiology
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更新日期:2007-10-01 00:00:00
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journal_title:Journal of cardiology
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doi:
更新日期:2007-06-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1993-01-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Journal of cardiology
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更新日期:2012-12-01 00:00:00
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journal_title:Journal of cardiology
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journal_title:Journal of cardiology
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journal_title:Journal of cardiology
pub_type: 杂志文章
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更新日期:1991-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
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更新日期:1992-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章,评审
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journal_title:Journal of cardiology
pub_type: 杂志文章
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journal_title:Journal of cardiology
pub_type: 杂志文章
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journal_title:Journal of cardiology
pub_type: 杂志文章
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更新日期:1993-01-01 00:00:00
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journal_title:Journal of cardiology
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