Korean J Crit Care Med.  2002 Nov;17(2):100-106.

Endoventricular Circular Patch Plasty and Intra-operative and Post-operative Care for Patients with Ischemic Cardiomyopathy

Affiliations
  • 1Department of Anesthesiology, Seoul National University, College of Medicine, Seoul, Korea. hambm@anu.ac.kr
  • 2Department of Cardiovascular Surgery, Seoul National University, College of Medicine, Seoul, Korea.

Abstract

BACKGROUND: Endoventricular circular patch plasty (EVCPP)was introduced as an effective reconstructive procedure for ventricular aneurysm and diffuse dilated cardiomyopathy after myocardial infarction.We report the 4-year results of EVCPP in Seoul National University Hospital, the experiences of anesthesia and intensive care for EVCPP in patients with ischemic cardiomyopathy.
METHODS
EVCPP has been performed on 31 patients (22 men and 9 women wit h a mean age of 62 years)during 4 years from March 1998 to March 2002.Six patients (19%)were NYHA cl ass II,24 pat i ent s were cl ass III,and 1 pat i ent was cl ass I V.Preoperative and postoperative left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),ejection fraction (EF)were determined and compared.Transesoghageal echocardiograghy (TEE)was used to measure the distance between aortic annulus and ventricular aneurysm during EVCPP.Milrinone combined with beta -adrenergics was infused during separation from cardiopulmonary bypass (CPB) and in the intensive care unit.
RESULTS
Three patients (10%)needed an intra-aortic balloon pump to wean from CPB and one patient (3%)died in the hospital.Out of 30 survivors,29 patients returned to NYHA class I or II and one patient to class III.Out of 30 patients who underwent echocardiographic study before and after EVCPP,EF increased from 34 +/-9%to 38 +/-10%,and LVEDV and LVESV decreased from 139 +/-43 ml to 94 +/-20 ml and from 90 +/-34 ml to 59 +/-17 ml,respectively.
CONCLUSIONS
EVCPP is effective to exclude the akinetic left ventricular segment,thus improving left ventricular function and clinical status of patients with ischemic cardiomyopathy.However, studies concerning postoperative intensive care are warranted to reduce the postoperative complications and morbidity.

Keyword

Ejection fraction; Endoventricular circulatr patch plasty; Milrinone; beta-adrenergics

MeSH Terms

Anesthesia
Aneurysm
Cardiomyopathies*
Cardiomyopathy, Dilated
Cardiopulmonary Bypass
Echocardiography
Equidae
Female
Humans
Critical Care
Intensive Care Units
Male
Milrinone
Postoperative Complications
Seoul
Stroke Volume
Ventricular Function, Left
Milrinone
Full Text Links
  • KJCCM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr