A Surgical Case of Midventricular Hypertrophic Obstructive Cardiomyopathy with Apical Aneurysm / 日本心臓血管外科学会雑誌

Hypertrophic cardiomyopathy with apical aneurysm is known to have high risk of a sudden death due to ventricular arrhythmias or thromboembolisms. We report a surgical case of surgical case of this disease. A 67-year-old man was found to have abnormality in an electrocardiogram during his checkup, and subsequent careful examinations revealed his disease. He had no symptoms and the pressure gradient at the obstruction was about 30 mmHg, but there was thrombus in the apical aneurysm. After anticoagulant therapy, the thrombus dissolved. We scheduled an operation on him because he was judged to have high risk of a sudden death. In the operation, excision of the apical aneurysm, and hypertrophic midventricular myocardium were performed, concomitant with cryoablation to the border between the aneurysm and normal myocardium. Although complete atrioventricular block occurred postoperatively and he needed permanent pacemaker implantation, he was discharged from the hospital 21 days postoperatively without any other complications. He is doing well at two years and six months, postoperatively.

Comparative study of left ventricular hemodynamic changes after Revivent surgery by dual‐modality imaging / 中华超声影像学杂志

Objective To investigate the hemodynamic changes before and after Revivent surgery in patients with left ventricular apical aneurysm by cardiac magnetic resonance imaging ( CM R ) and echocardiography . Methods Twenty‐two cases with left ventricular apical aneurysm were examined by two‐dimensional and three‐dimensional transthoracic echocardiography 1 week before operation ,1 month and 12 months after operation ,by CM R 1 week before operation and 12 months after operation .Left ventricular end‐diastolic volume( LVEDV ) ,left ventricular end‐systolic volume ( LVESV ) ,left ventricular end‐diastolic diameter ( LVEDd ) , left ventricular end‐systolic diameter ( LVESd ) , left ventricular ejection fraction ( LVEF) ,stroke volume ( SV ) ,stroke output index ( SVI) ,cardiac output ( CO ) and cardiac output index ( CI) were quantitatively measured and statistical analysis were performed . Results T here were significant differences between preoperation and 1 month after operation for the measurements of LVEDV ,LVESV , LVEDd and LVEF by both CM R and echocardiography ( all P ＜ 0 .05 ) . Compared with preoperation , LVESd decreased significantly 12 months after operation ( P ＜0 .01) . However ,there were no significant differences between preoperation and 1 or 12 months after operation for the measurements of SV ,SVI ,CO and CI ( all P ＞ 0 .05 ) . T he consistency between CM R and echocardiography measurements was good . Conclusions Revivent surgery provides an effective and feasible treatment for patients with left ventricular apical ventricular aneurysm . T he dual‐modality imaging with CM R and echocardiography are reliable technical means to evaluate the changes of left ventricular heamodynamiscs during the perioperative period of Revivent

Assessment of left ventricular hemodynamics and systolic function in patients with apical aneurysm after percutaneous ventricular restoration by echocardiography / 中华超声影像学杂志

Objective To evaluate the changes of left ventricular hemodynamics and systolic function in patients with apical aneurysm after percutaneous ventricular restoration ( PVR) by echocardiography . Methods Fifty patients with apical aneurysm were divided into PVR group ( 25 cases) and conservative treatment group ( control group ,25 cases ) . Two-dimensional transthoracic echocardiography ( 2D-TTE ) combined with real-time three-dimensional transesophageal echocardiography( RT-3DTEE) were applied for all the subjects in PVR group on preoperative ,one week after operaction ,three months after operaction and in control group on initial stage of prevent ventricular remodeling therapy ,one week after therapy ,three months after therapy to obtain left ventricular end-diastolic diameter( LVEDD) ,left ventricular end-systolic diameter( LVSDD) ,left ventricular end-diastolic volume( EDV ) ,end-systolic volume( ESV ) ,left ventricular ejection fraction( LVEF) ,left ventricular fractional shortening ( LVFS ) ,body surface area ( BSA ) ,stroke volume( SV) ,stroke volume index ( SVI) ,cardiac output ( CO ) ,cardiac output index ( CI) . Results There were significant differences in all parameters( P < 0 .05) especially in LVEF and SVI( P < 0 .01) between PVR group and control group in the following three months after operaction ,while there was no significant difference of the following one week after operaction( P > 0 .05) .Compared with preoperative ,there was no difference in all parameters in the following one week after operaction ( P > 0 .05) ,there was significant increase in SV and significant reduce in LVEDD and EDV ( P < 0 .01) between preoperative and in the following three months after operaction ,while there was no significant difference between preoperative and in the following one week after operaction ( P > 0 .05 ) .For the control group there was no significant difference between initial stage of prevevt ventricular remodeling therapy and in the following one week or three months after operaction .Conclusions PVR has a definite effect on left ventricular hemodynamics and systolic function in patients with apical aneurysm in the short term ,while 2D-TTE and RT-3DTEE provides a reliable basis for clinical to evaluate the effect of the PVR .

Immediate effect of percutaneous ventricular restoration on cardiac output of ischemic cardiomyopathy patients with apical aneurysm / 中国介入心脏病学杂志

Objective To evaluate the immediate effect of percutaneous ventricular restoration (PVR) using the PARACHUTE system in ischemic cardiomyopathy patients with apical aneurysm.Methods The study included 25 patients who received PARACHUTE partitioning device (PVD) implantation in the Xiamen Cardiovascular Hospital between January 2015 to December 2016.Invasive left ventricular hemodynamic assessments as well as cardiac output and cardiac output index were analyzed.Results Twenty-five patients [mean age (65.4±11.9) years] suffered from left ventricular aneurysm and heart failure patients after anterior myocardial infarction were enrolled.Ventricular partitioning device implantation was successful in 24/25 (96.0%) patients.PVR was failed in 1 patient due to unable to land the PVD in a satisfactory location.After implantation, a significant increase in cardiac output [(3.83±0.72) L/min vs.(4.85±0.93) L/min, P<0.01] and cardiac index [(2.32±0.74) L/(min·m2) vs.(2.90±0.82) L/(min·m2), P<0.01] was found.Conclusions Our preliminary experience on percutaneous ventricular restoration using PARACHUTE system demonstrates its feasibility and safety with increase in cardiac output and cardiac index immediately following the device implantation.

Clinical Characteristics and Prognosis in Patients With Mid-ventricular Obstructive Hypertrophic Cardiomyopathy / 中国循环杂志

Objective: To describe the clinical characteristics with long-term prognosis in patients with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM). Methods: A total of 66 MVOHCM patients treated in our hospital were retrospectively studied for their morbidity, clinical characteristics and mortality. The cumulative survival rate was calculated by Kaplan-Meier method; the risk factors for cardiac death and cardiovascular events were analyzed by uni- and multivariate Cox proportional hazard model. Results: There were 66 (2.74%) patients suffering from MVOHCM among 2413 patients of hypertrophic cardiomyopathy and the average diagnostic age was (40.16 ± 14.64) years. With (7.30 ± 6.25) years of follow-up study, the cardiovascular mortality was 13.6% and unexplained syncope (HR=13.37, 95% CI: 1.65-114.46, P=0.015) was the independent predictor for cardiovascular death. There were 45.45% (30/66) patients experienced at least 1 time of cardiovascular event and the most frequent one was non-sustained ventricular tachycardia (NSVT); 19.70% (13/66) of patients combined with apical aneurysms, and they were more inclined to experience NSVT. Conclusion: MVOHCM patients usually have unfavorable prognosis with the higher incidence of cardiovascular events, some patients may develop apical aneurysm. The early diagnosis of MVOHCM is important for appropriate treatment.

Mid-Ventricular Hypertrophic Obstructive Cardiomyopathy Complicated by an Apical Aneurysm, Presenting as Ventricular Tachycardia

No abstract available.

Prevalência de aneurismas do ventrículo esquerdo em pacientes chagásicos crônicos de duas áreas do Estado do Piauí / Prevalence of left ventricular aneurysms among chronic Chagas disease patients from two areas in the State of Piauí, Brazil

Para avaliar a prevalência de aneurismas do ventrículo esquerdo, realizou-se um estudo transversal envolvendo uma coorte de 261 pacientes chagásicos crônicos (156 do município de João Costa e 105 de São do João do Piauí; 146 mulheres e 115 homens com idade média de 57,9 ± 14,2 anos). A avaliação cardiológica foi realizada por exame clínico, eletrocardiograma de repouso e ecocardiograma uni e bidimensional. Foram diagnosticados 23 (8,8 por cento) aneurismas do ventrículo esquerdo: 17 (6,5 por cento) no ápice, quatro (1,5 por cento) na parede posterior, um (0,4 por cento) na parede inferior e um (0,4 por cento) no septo interventricular. Cinco (1,9 por cento) pacientes de São João do Piauí apresentaram trombos associados com aneurismas apicais. A prevalência de aneurismas do ventrículo esquerdo foi maior entre os pacientes de São João do Piauí (13,3 por cento) e entre os homens (13,9 por cento), com diferença não significativa em função da faixa etária. Esses resultados revelam baixa prevalência de aneurismas do ventrículo esquerdo entre os pacientes de João Costa e elevada concentração de trombos entre os pacientes de São João do Piauí.

A cross-sectional study involving a cohort of 261 chronic Chagas disease patients (156 from the municipality of João Costa and 105 from São João do Piauí; 146 women and 115 men with mean age of 57.9 ± 14.2 years) was carried out to evaluate the prevalence of left ventricle aneurysms. The cardiological evaluation was performed by means of clinical examination, resting electrocardiograms and one and two-dimensional echocardiograms. A total of 23 cases of left ventricle aneurysms (8.8 percent) were diagnosed: 17 (6.5 percent) in the apical segment, four (1.5 percent) in the posterior wall, one (0.4 percent) in the inferior wall and one (0.4 percent) in the interventricular septum. Five patients (1.9 percent) from São João do Piauí presented thrombi associated with apical aneurysms. The prevalence of left ventricle aneurysms was greater among the patients from São João do Piauí (13.3 percent) and among men (13.9 percent), with no significant difference in relation to age group. These results show that there was low prevalence of left ventricle aneurysms among patients from João Costa and high concentration of thrombi among patients from São João do Piauí.

Pseudoaneurisma ventricular. Evolución clínica y ecocardiográfica / Ventricular pseudoaneurysm. Clinical and echocardiographic evolution

Presentamos el caso de un paciente con una ruptura cardíaca secundaria a un infarto miocárdico al nivel del ápex del ventrículo izquierdo. La complicación mecánica condicionó la formación de un pseudoaneurisma que fue ocupado por un trombo que selló el punto de ruptura. El paciente sobrevive sin tratamiento quirúrgico tras 5 años de seguimiento.

The case of a patient with cardiac rupture following a myocardial infarction is presented. The rupture led to the formation of a ventricular pseudoaneurysm that was occupied by a thrombus that sealed the breakthrough point. The patient has survived without surgical treatment during the last 5 years. (Arch Cardiol Mex 2005; 75: 182-183).