OBJECTIVES: Controversy still exists regarding the optimal surgical technique for postinfarction dyskinetic @entity1002 ( @entity1002 ) repair. We compared the efficacy of two established techniques, linear vs. patch remodeling, for repair of @entity1002 . @entity1 AND METHODS: From 1989 to 1998, 95 (16 @entity1 , 79 @entity1 ) consecutive @entity1 were operated on for postinfarction @entity1002 . Thirty-four @entity1 underwent patch remodeling (R) and 61 linear (L) repair. The mean age was 61.1+/-8.5 years. Indications for surgery alone or in combination included angina in 72 @entity1 , @entity1353 in 64 and @entity1165 in 41. Thirty-seven @entity1 had a history of @entity712 (R 13 (38%), L 24 (39%), NS). The mean ejection fraction (EF) with @entity439 was 0.29+/-0.09 in R vs. 0.35+/-0.10 in L (P<0.04), whereas the mean EF without @entity439 was 0.43+/-0.11 in R vs. 0.46+/-0.08 in L (P=0.3). Seventy-one @entity439 were anterior (R 30 (88%), L 41 (68%), P<0.05). Concomitant coronary artery bypass grafting was performed in 84 @entity1 (R 29 (85%), L 55 (90%), NS). Follow-up ranged from 1 to 12 years (mean 5.6+/-3.4 years, median 6.1 years). RESULTS: Early mortality was 8% (n=8) (R 4, @entity14331 , NS). Survival at 1, 5 and 10 years was 88, 73, and 44%, respectively. It did not differ significantly between R (1 and 5 year survival 85, 66%) and L (90, 76%, P=0.58). Preoperative risk factors for mortality were history of @entity712 (1 and 5 year survival 81 and 57% vs. 90 and 78%, respectively, hazard ratio (HR)=1.95, P<0.05), non-anterior localization of the @entity439 (86 and 49% vs. 86 and 77%, HR=2.06, P<0.05), history of @entity1031 events (57 and 19% vs. 89 and 74%, HR=3.27, P<0.05), and left ventricular EF (HR=0.97 per %, P=0.05). At late follow-up the mean functional class was 1.8+/-0.6 in long-term survivors (preoperative 2.9+/-0.9, P<0.001) with no difference between the groups. CONCLUSIONS: The technique of repair of postinfarction @entity1002 should be adapted in each @entity1 to the cavity size and extent of the scarring process into the septum and subvalvular mitral apparatus. Applying these considerations to the choice of the technique of repair, both techniques achieved satisfactory results with respect to perioperative mortality, late functional status and survival.

Repair of postinfarction XXXX with either linear or patch technique.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'PATIENTS', 'men'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure'] @entity1165 :: ('MESH:D017180', 'Disease') :: ['ventricular tachycardia'] @entity1353 :: ('MESH:D004417', 'Disease') :: ['dyspnea'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms', 'aneurysm'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolic'] @entity14331 :: ('6124', 'Gene') :: ['L 4'] @entity1002 :: ('MESH:D018487', 'Disease') :: ['left ventricular aneurysm', 'dyskinetic LVA', 'LVA']
@entity439 :: (MESH:D000783,Disease) :: ['dyskinetic LV aneurysm']
