Background: Eight-year experience with the septal anterior ventricular exclusion procedure for congestive heart failure due to idiopathic dilated cardiomyopathy was evaluated.
Methods: In 36 patients (27 men and 9 women with a mean age of 60 years) with heart failure; New York Heart Association class III/IV (21/15); and mitral regurgitation 2+ or greater, the procedure was indicated when the diastolic dimension was 75 mm or greater, and the septum was akinetic. A long, narrow oval patch was sutured to form a downsized elliptical left ventricle by excluding the septum and anterior wall. Mitral reconstruction was combined for all patients (26 repairs with undersized ring and 10 replacements with bioprosthesis) and tricuspid repair was added for 16 patients (44%).
Results: Hospital mortality was 13.8% (5 of 36), with 6.5% (2 of 31) in elective and 60% (3 of 5) in emergency operations. Ejection fraction increased from 20.9% +/- 6.4% to 27.5% +/- 8.8%, left ventricular diastolic dimension decreased from 81.9 +/- 9.2 mm to 70.1 +/- 10.0 mm, and left ventricular endodiastolic and endosystolic volume indices decreased from 236.5 +/- 65.0 mL/m2 to 183 +/- 60.5 mL/m2 and from 181.3 +/- 55.4 mL/m2 to 133.5 +/- 54.1 mL/m2, respectively. Left ventricular endodiastolic pressure decreased from 24.3 +/- 9.7 mm Hg to 19.4 +/- 7.6 mm Hg. Brain natriuretic peptide decreased from 975 +/- 866 pg/mL to 404 +/- 366 pg/mL at 1 to 6 postoperative months. Eleven late deaths were noted and were due to heart failure (6), sudden death (4) and stroke (1). The mean New York Heart Association class was 1.7 among the survivors. One- and 3-year survival rates were 67.5% and 60.7%, respectively.
Conclusions: The septal anterior ventricular exclusion procedure with mitral reconstruction is a useful option for the treatment of advanced idiopathic dilated cardiomyopathy in extremely dilated left ventricle with akinetic septum.
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http://dx.doi.org/10.1016/j.athoracsur.2006.04.096 | DOI Listing |
J Craniofac Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark.
Background: Nasal septal abscesses (NSA) necessitate prompt recognition and management to prevent morbidity and long-term sequelae. To date, no comprehensive review of NSA alone has been conducted.
Objective: To conduct a systematic review of the presentation and management of NSA and determine patients at risk of sequelae.
Eur Heart J Case Rep
January 2025
Department of Cardiology, Klinik Landstrasse, Juchgasse 25, A-1030 Wien, Austria.
Background: Atrial flutter (AFL) is usually effectively treated by cavotricuspid isthmus (CTI) ablation. If AFL recurs despite ablation, there is risk of progression to atrial fibrillation (AF) and clinicians should consider underlying structural heart diseases. This consideration becomes especially critical when right-heart-chambers are dilated.
View Article and Find Full Text PDFJ Echocardiogr
December 2024
Division of Cardiovascular Surgery, Nagano Children's Hospital, Nagano, Japan.
Background: Perimembranous ventricular septal defect (VSD) can be classified as having trabecular, inlet, or outlet extension. The surgical approach used in patch closure depends on the which valve of the tricuspid valve to suture around and the avoidance of the specialized conducting system. This retrospective study evaluated the usefulness of the "En face view" method for classifying perimembranous VSD.
View Article and Find Full Text PDFLaryngoscope
December 2024
Beckman Laser Institute & Medical Clinic, University of California - Irvine, Irvine, California, U.S.A.
Objective: Repositioning and fixation of the posterior septal angle (PSA) relative to the anterior nasal spine (ANS) is a well-known maneuver performed during rhinoplasty. Suture techniques through the periosteum along with transosseous drilling through the spine are the two most common fixation methods. We report on how nasal airway patency varies as a function of technique and patient demographic factors.
View Article and Find Full Text PDFBMC Cardiovasc Disord
December 2024
Departmentof Cardiology, Wuhan Asia Heart Hospital, Wuhan, China.
Background: Coronary Artery Spasm (CAS) often presents in the epicardial coronary arteries. The anterior septal branch is distributed within the myocardium, and occurrences of spasms are rare. Currently, there is no available literature on this topic, and the onset of symptoms remains elusive, potentially leading to misdiagnosis.
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