Clinical improvement after ventricular aneurysm repair: prediction by angiographic and hemodynamic variables.
Clinical improvement after ventricular aneurysm repair: prediction by angiographic and hemodynamic variables.
复制标题
室动脉瘤修复后的临床改善：通过血管造影和血流动力学变量进行预测。
DOI：
10.1016/s0735-1097(83)80373-8
复制
发表时间：
1983
影响因子：
24
通讯作者：
J. Curtis
中科院分区：
文献类型：
--
作者：
S. Kiefer;G. Flaker;R. Martin;J. Curtis
左心室动脉瘤的手术修复与显着的围手术期死亡率和术后前 2 年的大量死亡率相关。对 42 名接受前心尖动脉瘤修复的患者进行回顾性分析，确定了两个心导管插入术变量可以预测良好的手术结果，即围手术期生存率和功能状态的改善。具体而言，左心室收缩段（非动脉瘤性）射血分数为 35% 或更高且左心室舒张末期压力为 25 mm Hg 或更低的患者围手术期死亡率较低 (6.5%)，无晚期死亡率，且至少一项纽约心脏协会功能分级 (93.5%) 的临床持续改善。相比之下，收缩截面射血分数小于35%或左心室舒张末压大于25 mm Hg的患者围手术期死亡率较高（27.3%），晚期死亡率较高（27.3%）或功能等级无显着改善（9%）；只有36.4%的患者获得了持续的临床改善。本研究表明，左心室动脉瘤修复术后的结果取决于未切除左心室的血流动力学状态。
Surgical repair of a left ventricular aneurysm is associated with significant perioperative mortality and substantial mortality in the first 2 years after operation. In a retrospective review of 42 patients undergoing repair of an anteroapical aneurysm, two cardiac catheterization variables were identified that predicted a good surgical outcome, defined as perioperative survival and improved functional status. Specifically, patients with an ejection fraction of the contractile section (nonaneurysmal) of the left ventricle of 35% or greater and a left ventricular end-diastolic pressure of 25 mm Hg or less had a low perioperative mortality rate (6.5%), experienced no late mortality and had sustained clinical improvement of at least one New York Heart Association functional class (93.5%). In contrast, patients with a contractile section ejection fraction of less than 35% or a left ventricular end-diastolic pressure greater than 25 mm Hg had a higher perioperative mortality rate (27.3%), experienced a substantial late mortality rate (27.3%) or had no significant functional class improvement (9%); only 36.4% had sustained clinical improvement.This study suggests that the postoperative results of left ventricular aneurysm repair are dependent on the hemodynamic status of the nonresected left ventricle.