Late results of endoventricular patch plasty repair in akinetic and dyskinetic areas after acute myocardial infarction

Arq Bras Cardiol. 2002 Aug;79(2):107-16. doi: 10.1590/S0066-782X2002001100002.

Abstract

Objective: To assess the surgical results of endoventricular patch plasty repair in akinetic and dyskinetic left ventricular areas.

Methods: We studied 52 patients who had undergone endoventricular patch plasty repair associated with myocardial revascularization. The preoperative functional class distribution was as follows: class I in 1 (1.9%) patient; class II in 2 (3.8%) patients; class III in 23 (44.2%) patients; and class IV in 26 (50%) patients.

Results: The immediate mortality rate was 7.6% (4 patients). The clinical outcome of 44 patients followed up within a mean postoperative time of 29+/-25 months was as follows: class I in 33 (75%) patients; class II in 7 (15.9%) patients; class III in 2 (4.5%) patients; and class IV in 2 (4.5%) patients. Comparison between pre- and postoperative catheterization in 21 patients showed that the ejection fraction increased from 46.3% to 51.3% (p=0.17); the left ventricular systolic volume decreased from 76.4 mL to 57.5 mL, (p=0.078); and the left ventricular diastolic volume decreased from 141.2 mL to 105.8 mL (p=0.0 73). These findings showed the tendency toward improvement, but with nonsignificant results.

Conclusion: The technique proved to be effective, to have a low mortality rate, to cause significant clinical improvement, an increase in ejection fraction, and a reduction in left ventricular volumes.

MeSH terms

  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Heart Aneurysm / etiology
  • Heart Aneurysm / physiopathology
  • Heart Aneurysm / surgery*
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / surgery*
  • Myocardial Revascularization
  • Postoperative Period
  • Treatment Outcome
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / surgery*