Severe diastolic dysfunction after endoventriculoplasty

Maurizio Salati, Antonella Pajè, Pietro Di Biasi, Pino Fundaró, Alessandro Cialfi, Carmine Santoli

Research output: Contribution to journalArticle

Abstract

Endoventriculoplasty with pericardial patch has been advocated to repair anteroseptal ventricular aneurysm, but no studies have reported the influence of this technique on diastolic left ventricular function. We have evaluated the changes on ventricular filling by means of pulsed Doppler recording of diastolic transmitral flow. Doppler analysis reveals three distinct spectral patterns: (1) normal, (2) inverted, and (3) restrictive. We have found an abrupt change from a preoperative normal to postoperative restrictive pattern in a significant minority of patients (8%) who underwent endoventriculoplasty. These patients had clinical and hemodynamic signs (New York Heart Association class, time from anterior myocardial infarction, left ventricular end-diastolic pressure, pulmonary hypertension, and mitral regurgitation) of severe impairment but no differences were found in ejection fraction, aneurysmal extension, or remote myocardial function. Moreover, after operation they had a satisfactory ejection fraction, a low end-diastolic volume, and an apex-base length shorter than the predicted value for a normal population. The presence of a postoperative restrictive pattern of diastolic filling is a strong predictor of 3-month mortality and makes the medical treatment difficult. Caution must be taken to perform endoventriculoplasty in patients who are severely ill, especially those recently affected by myocardial infarction. When the clinical conditions dictate the operation, a nonenthusiastic volume reduction seems to be a prudent option. (J THORAC CARDIOVASC SURG 1995;109:694-701).

Original languageEnglish
Pages (from-to)694-701
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume109
Issue number4
DOIs
Publication statusPublished - 1995

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Fingerprint Dive into the research topics of 'Severe diastolic dysfunction after endoventriculoplasty'. Together they form a unique fingerprint.

Cite this