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Left Ventricular Reconstruction after Dor-Sailing Close to the Wind?
Clara Großmann1, Ihor Krasivskyi1, Ilija Djordjevic1
1Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany.
Insights
Left ventricular aneurysm (LVA) after heart attack can be successfully treated with left ventricular reconstruction surgery. This procedure is safe and effective, improving ejection fraction and patient outcomes when performed by experienced surgeons.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Postinfarction left ventricular aneurysm (LVA) is a serious complication of myocardial infarction with a historically poor prognosis.
- Improved treatments have reduced LVA incidence, but the COVID-19 pandemic may be linked to a resurgence.
Purpose of the Study:
- To evaluate the safety and efficacy of left ventricular reconstruction for LVA.
- To assess outcomes in patients undergoing surgical repair of postinfarction LVA.
Main Methods:
- Retrospective, single-center cohort study.
- Analysis of 17 patients who underwent left ventricular reconstruction following myocardial infarction.
Main Results:
- Mean intensive care unit stay was 8 ± 16 days.
- 30-day mortality rate was 6%.
- Mean postoperative ejection fraction improved to 44 ± 8%, with improvement in all but three patients.
Conclusions:
- Left ventricular reconstruction is a safe and effective treatment for patients with LVA.
- Early surgical consideration should be given to patients with LVA, particularly when performed by experienced surgical teams.
Abstract:
Postinfarction left ventricular aneurysm (LVA) still remains a complication after myocardial infarction with a poor prognosis. Its incidence has decreased due to improved treatment, however, it may have experienced a renaissance due to the coronavirus disease 2019 pandemic. In this retrospective, single-center cohort study, we analyzed n = 17 patients who underwent left ventricular reconstruction after Dor. The results show a mean intensive care unit stay of 8 ± 16 days and a 30-day mortality rate of 6%. Mean postoperative ejection fraction was 44 ± 8% indicating an increase in all but three cases. This suggests that patients with an LVA can be successfully treated, and it is safe when performed by experienced surgeons. Therefore, they should still be considered for surgery early on.
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