RESUMO
METHODS: 1. All patients had preoperative investigations including coronary angiography and left ventriculography. 2. Clinical symptoms, functional outcome and survival rate were analyzed from medical records, patient's follow-up visits, and communications from the referring physicians. 3. All survivors were assessed for clinical functional status and survival rate at the most recent follow-up visits. MAIN OUTCOME MEASURES: long-term postoperative survival rate and the improvement of clinical outcomes. RESULTS: Repair of the left ventricular aneurysm alone was performed in 9 patients (19.15%). Repair of the left ventricular aneurysm combined with coronary artery bypass grafting was performed in 38 patients (80.85%). There was only one death (2.13%) in this study. There was a significant increase in the postoperative mean ejection fraction (EF) of the left ventricle (LV) of 16.83+/-4.93% (p < 0.01) when compared to the preoperative mean EF of the LV. Long-term follow-up of linear repair of the left ventricular aneurysm at a mean of 12.96 years was carried out. 78.13% of patients clinically improved according to the New York Heart Association (NYHA) functional class and Kaplan-Meier's method long-term survival rate of 66.61%. CONCLUSION: Left ventricular aneurysm was best managed by surgical repair with improvement in quality of life.
Assuntos
Aneurisma Cardíaco/cirurgia , Adulto , Idoso , Causas de Morte , Angiografia Coronária , Ponte de Artéria Coronária , Feminino , Seguimentos , Imagem do Acúmulo Cardíaco de Comporta , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Qualidade de Vida , Estudos Retrospectivos , Volume Sistólico/fisiologia , Taxa de Sobrevida , Resultado do Tratamento , Função Ventricular Esquerda/fisiologiaAssuntos
Malformações Arteriovenosas , Anomalias dos Vasos Coronários , Adulto , Humanos , MasculinoRESUMO
Single aorta-coronary artery vein grafts (bridge grafts) were constructed to two coronary branches with a side-to-side anastomosis in 250 patients. Most of these grafts were constructed between circumflex branches (96 grafts), circumflex and diagnol branches (47 grafts), and anterior descending and diagonol branches (79 grafts). The aim of the bridge graft is to decrease the number of anastomoses, decrease the operative time, and improve graft patency. The hospital mortality rate in this group of patients was 1.2 per cent, and the incidence of postoperative myocardial infarction was 3.6 per cent. One hundred ten patients were restudied after surgery; the average time of restudy was 1 year. Ninety-two grafts of 83.6 per cent had two anastomosis patent; 6 grafts (5.4 per cent) had one anastomosis patent; and in 12 grafts (10.9 per cent), both anastomoses were occluded. One hundred twenty-six associated grafts were studied all the same time; the patency rate was 84.1 per cent. From this experience, we believe the bridge graft is a useful procedure for bypassing the small coronary artery branches.
