Safety and efficacy of surgical ventricular restoration in unstable patients with recent anterior myocardial infarction

Circulation
Marisa Di DonatoLorenzo Menicanti

Abstract

The effects and efficacy of surgical ventricular restoration (SVR) in ischemic cardiomiopathy caused by chronic anterior myocardial infarction (MI) are well established. Normally, SVR is delayed at least 3 months after MI to allow the healing of infarcted tissue. Some patients have instability <30 days after anterior MI, with increased risk for morbidity and mortality.Objectives- This study tests the safety and efficacy of SVR in the setting of subacute complicated anterior MI, in terms of early and late outcome. 74 patients (62+/-10 years) were submitted to SVR at < or =30 days after anterior MI for clinical instability and were retrospectively selected from a series of 430 patients undergoing SVR at our center, between 1998 and 2001. The surgical indications included: angina (60%); New York Heart Association class 4 (62%); clinical signs of heart failure (18%); life-threatening arrhythmias (12%); and cardiogenic shock in 4% (or 3) patients. Follow-up is available for 93% of patients. All patients had coronary artery bypass grafting (CABG) (3.1+/-1.2) with internal mammary artery (IMA) utilization. An endoventricular patch was used in 17 patients (23%); direct ventriculotomy closure was used in the remaining patients. Operativ...Continue Reading

Citations

Aug 13, 2010·General Thoracic and Cardiovascular Surgery·Yasuhiro ShudoYoshiki Sawa
Nov 21, 2007·The Journal of Thoracic and Cardiovascular Surgery·Marisa Di DonatoLorenzo Menicanti
Jan 24, 2009·The Annals of Thoracic Surgery·Marisa Di DonatoLorenzo Menicanti
Nov 19, 2005·Expert Review of Cardiovascular Therapy·Anita PritisanacHelmut Gulbins
May 29, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Marisa Di DonatoLorenzo Menicanti

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