Left Ventricular Reconstruction Surgery in Candidates for Heart Transplantation.

Autor:	Contreras CAM; Instituto Dante Pazzanese de Cardiologia Division of Cardiovascular Surgery São Paulo SP Brazil Division of Cardiovascular Surgery of Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil., Orellana PX; Instituto Dante Pazzanese de Cardiologia Division of Cardiovascular Surgery São Paulo SP Brazil Division of Cardiovascular Surgery of Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil., Almeida AFS; Instituto Dante Pazzanese de Cardiologia Division of Cardiovascular Surgery São Paulo SP Brazil Division of Cardiovascular Surgery of Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil., Finger MA; Instituto Dante Pazzanese de Cardiologia Division of Cardiovascular Surgery São Paulo SP Brazil Division of Cardiovascular Surgery of Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil., Rossi JM Neto; Instituto Dante Pazzanese de Cardiologia Division of Cardiovascular Surgery São Paulo SP Brazil Division of Cardiovascular Surgery of Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil., Chaccur P; Instituto Dante Pazzanese de Cardiologia Division of Cardiovascular Surgery São Paulo SP Brazil Division of Cardiovascular Surgery of Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Brazilian journal of cardiovascular surgery [Braz J Cardiovasc Surg] 2019 Jun 01; Vol. 34 (3), pp. 265-270. Date of Electronic Publication: 2019 Jun 01.
DOI:	10.21470/1678-9741-2018-0087
Abstrakt:	Objective: To report our center's experience in the surgical treatment of ventricular reconstruction, an effective and efficient technique that allows patients with end-stage heart failure of ischemic etiology to have clinical improvement and increased survival. Methods: Observational, clinical-surgical, sequential, retrospective study. Patients with ischemic cardiomyopathy and left ventricular aneurysm were attended at the Heart Failure, Ventricular Dysfunction and Cardiac Transplant outpatient clinic of the Dante Pazzanese Cardiology Institute, from January 2010 to December 2016. Data from 34 patients were collected, including systemic arterial hypertension, ejection fraction, New York Heart Association (NYHA) functional classification (FC), European System for Cardiac Operative Risk Evaluation (EuroSCORE) II value, Society of Thoracic Surgeons (STS) score, ventricular reconstruction technique, and survival. Results: Overall mortality of 14.7%, with hospital admission being 8.82% and late death being 5.88%. Total survival rate at five years of 85.3%. In the preoperative phase, NYHA FC was Class I in five patients, II in 18, III in eight, and IV in three vs. NYHA FC Class I in 17 patients, II in eight, III in six, and IV in three, in the postoperative period. EuroSCORE II mean value was 6.29, P≤0.01; hazard ratio (HR) 1.16 (95% confidence interval [CI] 1.02-1.31). STS mortality/morbidity score mean value was 18.14, P≤0.004; HR 1.19 (95% CI 1.05-1.33). Surgical techniques showed no difference in survival among Dor 81% vs. Jatene 91.7%. Conclusion: Surgical treatment of left ventricular reconstruction in candidates for heart transplantation is effective, efficient, and safe, providing adequate survival.
Databáze:	MEDLINE
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