1,721,000 research outputs found
[Surgical treatment of ischemic mitral regurgitation]. FT Trattamento chirurgico dell'insufficienza mitralica ischemica.
No full textThe impact of right ventricular function upon 2-year actual cardiac mortality of patients with ischemic mitral regurgitation undergoing mitral valve surgery
No full textIntermittent antegrade warm cardioplegia: warm blood versus cold crystalloid. A clinical study
No full textAbstract- Intermittent antegrade warm blood cardioplegia (IAWBC) is a not usual technique of myocardial protection. We propose a delivery protocol that standardizes the length of ischemic intervals, duration of each cardioplegic dose and K+ amount. Cardioplegia is represented by blood, taken from the oxygenator and injected directly into the aortic root, and K+, added by means of a syringe pump. We reviewed the first 300 patients who underwent elective or urgent coronary artery by-pass procedures (group A) and compared them with the last 300 patients operated on with intermittent antegrade cold crystalloid cardioplegia (group B). The overall mortality in group A was lower than in group B (0.7 vs 3.0, p < 0.05); there was no in-hospital death in patients with poor left ventricle (LVEF < 35%) in group A (0/64 vs 3/39, p < 0.025). Reduction of mortality was due to a drastic fall of morbidity. In group A no patients needed circulatory assistance (13 in group B, p < 0.0005) or intraaortic balloon pumping (9 in group B, p < 0.005) in operating room or in intensive care unit (ICU); only 1 patient had inotropic drug (29 in group B, p < 0.0005) and only 6 needed lignocaine infusion (27 in group B, p < 0.0005). Incidence of postoperative myocardial infarction was lower in group A (4 vs 9 in group B) as well cerebrovascular accidents (4 vs 10 in group B), but difference was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS
Mitral valve repair for dilated cardiomyopathy: predictive role of right ventricular dysfunction
No full textAims To evaluate the impact of right ventricular (RV) dysfunction on early and mid-term outcome of
patients with ischaemic or dilated cardiomyopathy (DCM) undergoing mitral valve annuloplasty.
Methods and results From January 1997 to December 2005, 111 patients with DCM (89 ischaemic,
22 non-ischaemic) were enrolled in this retrospective study. Mean age was 67+10 years. Average
pre-operative NYHA class was 3.0+0.6. Tricuspid annular plane systolic excursion (TAPSE), tricuspid
annular pleak systolic velocity (TAPSV), and RV fractional area change were considered as an index of
RV function. A strong relationship between TAPSE and TAPSV were found (r 1⁄4 0.76). Thirty-day mortality
was 10.8%. Five-year survival and possibility to be alive in NYHA classes I–II were 66.5+5.0 and 59.5+
5.0%. TAPSE, TAPSV, and MV coaptation depth (MVCD) were found to be risk factors for worse early and
mid-term outcome; functional class impaired mid-term outcome. ROC analysis identified TAPSE12
mm, TAPSV10 cm/s, and MVCD.10 mm as predictive cut-offs.
Conclusion Pre-operative assessment of some echocardiographic parameters (TAPSE, TAPSV) is very
easy, low cost, and provides accurate information on RV function. A good pre-operative clinical compensation
has to be necessarily reached before the operation. MVCD should be evaluated to decide surgical
strategy (repair or replace)
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