Surgical treatment of left ventricular aneurysm--assessment of risk factors for early and late mortality
| Autor: | Holmberg L, Sjörgren I, Elisabeth Ståhle, B. Edlund, S O Nyström, Reinhold Bergström |
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| Rok vydání: | 1994 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male Reoperation medicine.medical_specialty Multivariate analysis Heart disease Coronary Disease Ventricular Function Left Angina Pectoris Aneurysm Postoperative Complications Internal medicine Cause of Death medicine Myocardial Revascularization Humans cardiovascular diseases Derivation Hospital Mortality Heart Aneurysm Aged Proportional Hazards Models Heart Failure Proportional hazards model business.industry Hemodynamics General Medicine Middle Aged medicine.disease Combined Modality Therapy Surgery Survival Rate Left Ventricular Aneurysm medicine.anatomical_structure cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine Complication business Artery Follow-Up Studies |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 8(2) |
| ISSN: | 1010-7940 |
| Popis: | Consecutive patients operated on for left ventricular aneurysm from 1970 through August 1989 (n = 303) were evaluated with respect to survival. Early mortality, i.e. within 30 days, was 8.9%; 23% in patients who underwent aneurysm resection alone, 8.1% in cases of aneurysm resection with coronary artery bypass grafting (CABG), and 6.3% in those undergoing CABG only. Multivariate logistic regression revealed that advanced New York Heart Association (NYHA) functional class, non-use of the internal mammary artery as a graft and thromboendarterectomy increased the early risk. The total observed survival was 86% at 1 year, 72% at 5 years and 45% at 10 years. Multivariate analysis based on observed survival, using the Cox proportional hazards model, identified advanced NYHA functional class and non-use of the internal mammary artery as independent indicators of poor survival. Relative mortality, defined as the ratio of observed mortality in the study group to mortality among comparable persons from the general Swedish population, was used as a measure of disease-specific mortality. An apparent excess mortality in patients operated on for left ventricular aneurysm was found. A notable finding was that the use of the internal mammary artery to graft the left anterior descending artery improved the outcome substantially in patients with a left ventricular aneurysm. |
| Databáze: | OpenAIRE |
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