Abstract:
INTRODUCTION:Left ventricular aneurysm is a severe complication of acute myocardial infarction, which contributes significantly to mortality and morbidity associated with this pathology. Despite the progress of correction techniques, there are still controversies about the optimal approach addressing this pathology. AIM:The aim of this study was to analyse short and medium term outcomes of left ventricular reconstruction for ischemic left ventricular aneurysm using two surgical techniques (endoventricular patch plasty and liniar suture) in order to determine if one of these techniques has supperior results. METHOD:117 patients were included in the study, 48 patients (41%) underwent left ventricular reconstruction with endoventricular patch (Group 1), 69 patients (59%; Group 2) had linear reconstruction. 113 patients (96.5%) required associated procedures: 108 surgical myocardial revascularization, 18 mitral valvuloplasty and 8 ventricular septal defect closure. Short and medium term morbidity, mortality, alteration of ejection fraction and NYHA class were analysed. RESULTS:Perioperative mortality was 11.11%, 4.2% in the endoventricular patch group, and 15.9% in the linear suture group (p = 0.03). The overall 5-year survival was 78.5% (88.7% in Group 1 and 71.2% in Group 2). The left ventricular ejection fraction and NYHA functional class improved in both groups, with greater improvement in the endoventricular patch group. CONCLUSIONS:Surgical ventricular reconstruction is a procedure performed for the correction of ischemic left ventricular aneurysm with good early and medium-term results, but with better results with the endoventricular patch technique regarding early and medium-term mortality, ejection fraction and NYHA functional class improvement. Orv Hetil. 2018; 159(51): 2167-2174. :Absztrakt: Bevezetés: A balkamra-aneurysma az akut myocardialis infarctus súlyos szövődménye; jelentősen növeli a morbiditást, mortalitást. A sebészi korrekciós technikák fejlődése ellenére számtalan kérdőjel van e kórkép kezelésének optimális megközelítésével kapcsolatban. Célkitűzés: Tanulmányunk célja az ischaemiás eredetű balkamra-aneurysma két különböző sebészi technikával (endoventriculoplastica és lineáris varrat) végzett műtéti rekonstrukciója rövid és középtávú eredményeinek vizsgálata annak érdekében, hogy meghatározzuk, melyik eljárás előnyösebb. Módszer: A vizsgálatba 117 beteget vontunk be, 48 esetben (41%) endoventriculoplasticával (1. csoport), 69 betegnél (59%) lineáris varrattal (2. csoport) végeztük a balkamra-rekonstrukciót. 113 betegnél (96,5%) egy időben más eljárás is szükséges volt: 108 esetben műtéti myocardialis revascularisatio, 8 betegnél kamrai septumsutura, 18 esetben mitralisbillentyű-plastica történt. A rövid és középtávú morbiditást és mortalitást, az ejekciós frakció változásait és a szívelégtelenség súlyosságát (NYHA) elemeztük. Eredmények: A perioperatív mortalitás 11,11% volt, 4,2% az endoventriculoplasticás csoportban, 15,9% a lineárisvarrat-csoportban (p = 0,03). Az 5 éves túlélés 78,5% volt (88,7% az 1. csoportban és 71,2% a 2. csoportban). Mindkét csoportban javult a bal kamra ejekciós frakciója, a szív funkcionális osztályba sorolása (NYHA); az eredmények szignifikánsan jobbak voltak az endoventriculoplasticával műtött betegek csoportjában. Következtetések: A bal kamra műtéti rekonstrukciója jó korai és középtávú eredményeket mutató eljárás az ischaemiás balkamra-aneurysma korrigálására; az endoventriculoplastica jobb eredményeket biztosít a korai és középtávú mortalitás, az ejekciós frakció és a NYHA funkcionális osztály szempontjából. Orv Hetil. 2018; 159(51): 2167–2174.
journal_name
Orv Hetiljournal_title
Orvosi hetilapauthors
Balau R,Deac R,Kovacs J,Harpa M,Ghiragosian C,Al Hussein H,Suciu Hdoi
10.1556/650.2018.31226subject
Has Abstractpub_date
2018-12-01 00:00:00pages
2167-2174issue
51eissn
0030-6002issn
1788-6120journal_volume
159pub_type
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