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Efficacy of aneurysmectomy in patients with severe left ventricular dysfunction: favorable short-and long-term results in ischemic cardiomyopathy
Serrano Júnior, Carlos Vicente; Ramires, José A. F; Soeiro, Alexandre de Matos; César, Luiz Antônio M; Hueb, Whady A; Dallan, Luiz A; Jatene, Fábio B; Stolff, Noedir A. G.
Afiliação
  • Serrano Júnior, Carlos Vicente; s.af
  • Ramires, José A. F; s.af
  • Soeiro, Alexandre de Matos; s.af
  • César, Luiz Antônio M; s.af
  • Hueb, Whady A; s.af
  • Dallan, Luiz A; s.af
  • Jatene, Fábio B; s.af
  • Stolff, Noedir A. G; s.af
Clinics ; 65(10): 947-952, 2010. ilus, tab
Artigo em Inglês | LILACS | ID: lil-565975
Biblioteca responsável: BR1.1
ABSTRACT

INTRODUCTION:

The purpose of this study was to (1) identify the functional results after aneurysm surgery in patients with ischemic cardiomyopathy and (2) identify predictors of favorable outcomes. METHODS AND

MATERIAL:

Patients (n = 169) with angiographic left ventricular ejection fraction of 22±5 percent underwent aneurysm surgery and were prospectively followed for three years. Prior to surgery, 40 percent and 60 percent of the patients were in congestive heart failure NYHA class I/II and III/IV, respectively. Concomitant revascularization was performed on 95 percent of the patients.

RESULTS:

Cumulative in-hospital and 36-month mortalities were 7 percent and 15 percent, respectively. These respective rates varied according to preoperative parameters CHF class I-II, 4 percent and 13 percent; CHF class III-IV, 8 percent and 16 percent; LVEF,20 percent, 12 percent and 26 percent; LVEF 21-30 percent, 2 percent and 6 percent; gated LVEF exercise/rest .5 percent, ,1 percent and 4 percent; and gated LVEF exercise/rest #5 percent, 17 percent and 38 percent. Higher LVEF ex/rest ratio (p = 0.01), male sex (p = 0.05), and a higher number of grafts (p = 0.01) were predictive of improvement in CHF class at follow-up based on the results of a multivariate analysis. After three years of follow-up, 84 percent of the patients were in class I/II, LVEF was 45±7 percent, and gated LVEF ex/rest ratio was 13 percent higher (p,0.01) compared to the beginning of the study.

CONCLUSIONS:

These data suggest that aneurysmectomy among patients with severe LV dysfunction result in shortand long-term favorable functional outcome and survival. Selection of appropriate surgical candidates may substantially improve survival rates among these patients.
Assuntos

Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Doença Cardiovascular / Doença Isquêmica do Coração / Outras Doenças Circulatórias Base de dados: LILACS Assunto principal: Volume Sistólico / Isquemia Miocárdica / Disfunção Ventricular Esquerda / Aneurisma Cardíaco Tipo de estudo: Estudo prognóstico Limite: Adulto / Idoso / Feminino / Humanos / Masculino Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2010 Tipo de documento: Artigo
Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Doença Cardiovascular / Doença Isquêmica do Coração / Outras Doenças Circulatórias Base de dados: LILACS Assunto principal: Volume Sistólico / Isquemia Miocárdica / Disfunção Ventricular Esquerda / Aneurisma Cardíaco Tipo de estudo: Estudo prognóstico Limite: Adulto / Idoso / Feminino / Humanos / Masculino Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2010 Tipo de documento: Artigo
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