Severe diastolic dysfunction after endoventriculoplasty

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

Research output: Contribution to journalArticle

15 Citations (Scopus)

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

Fingerprint

Myocardial Infarction
Pulmonary Valve Insufficiency
Mitral Valve Insufficiency
Left Ventricular Function
Pulmonary Hypertension
Aneurysm
Reference Values
Hemodynamics
Blood Pressure
Mortality
Population
Therapeutics

ASJC Scopus subject areas

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

Cite this

Severe diastolic dysfunction after endoventriculoplasty. / Salati, Maurizio; Pajè, Antonella; Di Biasi, Pietro; Fundaró, Pino; Cialfi, Alessandro; Santoli, Carmine.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 109, No. 4, 1995, p. 694-701.

Research output: Contribution to journalArticle

Salati, Maurizio ; Pajè, Antonella ; Di Biasi, Pietro ; Fundaró, Pino ; Cialfi, Alessandro ; Santoli, Carmine. / Severe diastolic dysfunction after endoventriculoplasty. In: Journal of Thoracic and Cardiovascular Surgery. 1995 ; Vol. 109, No. 4. pp. 694-701.
@article{a7ee8974e09745e1bbe80e15caf3aba5,
title = "Severe diastolic dysfunction after endoventriculoplasty",
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).",
author = "Maurizio Salati and Antonella Paj{\`e} and {Di Biasi}, Pietro and Pino Fundar{\'o} and Alessandro Cialfi and Carmine Santoli",
year = "1995",
doi = "10.1016/S0022-5223(95)70350-0",
language = "English",
volume = "109",
pages = "694--701",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Severe diastolic dysfunction after endoventriculoplasty

AU - Salati, Maurizio

AU - Pajè, Antonella

AU - Di Biasi, Pietro

AU - Fundaró, Pino

AU - Cialfi, Alessandro

AU - Santoli, Carmine

PY - 1995

Y1 - 1995

N2 - 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).

AB - 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).

UR - http://www.scopus.com/inward/record.url?scp=0028968314&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028968314&partnerID=8YFLogxK

U2 - 10.1016/S0022-5223(95)70350-0

DO - 10.1016/S0022-5223(95)70350-0

M3 - Article

C2 - 7715216

AN - SCOPUS:0028968314

VL - 109

SP - 694

EP - 701

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 4

ER -