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

RESUMO

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 percent) patient; class II in 2 (3.8 percent) patients; class III in 23 (44.2 percent) patients; and class IV in 26 (50 percent) patients. RESULTS - The immediate mortality rate was 7.6 percent (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 percent) patients; class II in 7 (15.9 percent) patients; class III in 2 (4.5 percent) patients; and class IV in 2 (4.5 percent) patients. Comparison between pre- and postoperative catheterization in 21 patients showed that the ejection fraction increased from 46.3 percent to 51.3 percent (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