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1.
Ann Cardiol Angeiol (Paris) ; 71(1): 11-16, 2022 Feb.
Artigo em Francês | MEDLINE | ID: mdl-34144786

RESUMO

BACKGROUND: Ischemic heart disease with severe left ventricular systolic dysfunction is a poor prognosis. Coronary artery bypass grafting is the gold treatment in this population, despite high surgical risk. AIM: The aim of our study is to evaluate the short- and long-term outcomes of coronary artery bypass grafting in patients with ischemic heart disease and severe left ventricular systolic dysfunction (LVEF≤35%). METHODS: Between May 1995 and December 2010, 171 patients with ischemic heart disease and severe left ventricular systolic dysfunction (LVEF≤35%) underwent isolated coronary artery bypass grafting. Hospital mortality, postoperative morbidity, all-cause death, cardiovascular death, and major adverse cardiovascular events (heart failure, recurrent angina, myocardial infarction, stroke) were evaluated. The mean follow-up was 9.3±5 years. RESULTS: Hospital mortality was 9.9%. Postoperative morbidity was 36.9%. Overall survival at 1-, 5- and 10-years was 97.4%, 90.5% and 43.4%, respectively. Freedom from cardiovascular death at 1-, 5- and 10-years was 98.1%, 91.8% and 55.4%, respectively. Freedom from recurrent angina at 1-, 5- and 10-years was 95.5%, 84.8% and 44.9%, respectively. Freedom from heart failure at 1-, 5- and 10-years was 89.9%, 86,8% and 53.3%, respectively. Freedom from major adverse cardiovascular events at 1-, 5- and 10-years was 88%, 82.1% and 38.2%, respectively. CONCLUSION: Based on our findings, coronary artery bypass grafting can be performed in patients with ischemic heart disease and severe left ventricular systolic dysfunction with acceptable hospital morbidity and mortality and long-term survival.


Assuntos
Insuficiência Cardíaca , Disfunção Ventricular Esquerda , Angina Pectoris , Ponte de Artéria Coronária , Humanos , Fatores de Risco , Resultado do Tratamento
2.
Ann Cardiol Angeiol (Paris) ; 67(1): 25-31, 2018 Feb.
Artigo em Francês | MEDLINE | ID: mdl-28800856

RESUMO

INTRODUCTION: Ischemic Mitral Regurgitation (IMR) is a serious complication of coronary artery disease and is associated with a poor prognosis. The optimal surgical treatment of IMR involves controversies in its indications and modalities. OBJECTIVES: To determine whether mitral annuloplasty associated with surgical revascularization improved short and mid terms outcomes compared with revascularization alone in patients with IMR. METHODS: Between January 2007 and January 2011, 81 patients operated on Department of Cardiovascular Surgery "B" were included in this study divided into 3 groups. Group 1: 28 patients with IMR had mitral valve surgery associated with surgical revascularization. Group 2: 26 patients with IMR had surgical revascularization without mitral valve surgery. Group 3: 27 patients without IMR had isolated revascularization. Clinical end-points were operative mortality, late mortality, postoperative functional status (NYHA), and the Effective Regurgitant Orifice (ERO) at last follow-up. The mean follow-up was 5 years for groups 1 and 2 and 4 years for group 3. RESULTS: There was no difference between the 3 groups regarding age, sex, cardiovascular risk factors, and extension of coronary artery disease. The Left Ventricle End Diastolic Diameter (LVEDD) and the Left Ventricle Ejection Fraction (LVEF) were slightly different. Late and operative mortality were higher in group 2 compared to groups 1 and 3. Postoperative functional status (NYHA) improved both in groups 1 and 2. In group 1, there was a decrease in ERO. CONCLUSION: Mitral annuloplasty combined to revascularization improves symptoms, postoperative ERO and short- and mid-term survival compared with revascularization alone.


Assuntos
Anuloplastia da Valva Mitral , Insuficiência da Valva Mitral/cirurgia , Isquemia Miocárdica/cirurgia , Revascularização Miocárdica , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Anuloplastia da Valva Mitral/métodos , Insuficiência da Valva Mitral/complicações , Insuficiência da Valva Mitral/mortalidade , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/mortalidade , Revascularização Miocárdica/métodos , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
3.
Heart Lung Circ ; 24(1): e4-6, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25306499

RESUMO

We report the case of 50 year-old woman who presented with left ventricle outflow tract obstruction with discrete sub-aortic membrane 20 years following mitral valve replacement and tricuspid valve annuloplasty. We aim through this case, on one hand to report this unusual entity and on the other hand to discuss the underlying mechanisms as well as the therapeutic solutions.


Assuntos
Anuloplastia da Valva Cardíaca/efeitos adversos , Valva Mitral/cirurgia , Complicações Pós-Operatórias , Valva Tricúspide/cirurgia , Obstrução do Fluxo Ventricular Externo/etiologia , Adulto , Feminino , Humanos , Fatores de Tempo
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