[Analysis of the mechanical properties of the left ventricle in patients with aortic valve disease]. / Análise das propriedades mecânicas do ventrículo esquerdo em portadores de valvopatia aórtica.

The morphological and functional aspects of the left ventricle (LV) were assessed by echocardiography and cardiac catheterization performed simultaneously in 41 patients. Eleven were normal (N), 14 had aortic stenosis (AS) and 16 had aortic regurgitation (AR). Of the 14 patients with AS, eight were in New York Heart Association (NYHA) functional class I and II (ASA group) and six were in NYHA functional class III and IV (ASB group). Of the 16 patients with AR, seven were in NYHA functional class I and II (ARA group) and nine in functional class III and IV (ARB group). In the ASA group normal values of the LV function were obtained because of the development of an adequate hypertrophy that in normalizing the systolic stroke was able to keep a suitable function. In the ASB group there was a reduction of the LV function due to an increase of the systolic stroke and to the reduction of the contractile muscle state. Thus, in the whole AS group we found an inversed relation between the ejection fraction and the systolic stroke. In the ARA group we found a normal cardiac function as consequence of an adequate development of the LV dilation and hypertrophy. Despite the find of reduction of the contractile state, the systolic stroke normalizing was capable to keep the cardiac function at normal values. The ARB group presented an important depression of the cardiac function due the increase of the systolic stroke and to the decrease of the contractile state of the cardiac muscle.

Direct myocardial revascularization in young patients: analysis of 100 consecutive cases without operative mortality.

The authors studied a series of 100 patients submitted to direct myocardial revascularization before 40 years of age. One hundred and seventy-three saphenous vein by-passes and 4 mammary artery left descending coronary artery anastomoses were performed. There was no operative mortality and the late mortality was 2%. The period of postoperative clinical evaluation of the patients varied from 12 to 60 months (mean 32.0 months).