Quantitative analysis of regional systolic function with left ventricular aneurysm. Circulation 1988 Oct;78(4):856-62
Date
10/01/1988Pubmed ID
3168193DOI
10.1161/01.cir.78.4.856Scopus ID
2-s2.0-0023786753 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
Left ventricular aneurysm (LVA) remains a poorly understood entity, often resulting in congestive failure that is not consistently improved by standard resection with linear closure. Although other surgical approaches have been proposed, current methods to assess their effect on left ventricular function are not adequate. The purpose of the present study was to quantitatively define regional systolic function in patients with LVA and to assess acute changes in regional function after standard repair. Seven patients underwent resection of an anteroapical LVA. Intraoperative two-dimensional echocardiography was performed off cardiopulmonary bypass immediately before and after resection. In all patients, short-axis views at the papillary muscle (apex) level showed anteroseptal paradox and distorted geometry, whereas at the mitral valve (base), symmetric wall motion and geometry were preserved. Videotaped echo images were divided into octants by a floating axis fitted to internal landmarks. Myocardial area and midwall perimeter were obtained for each octant, and wall thickness was calculated at end diastole (ED), isovolumetric systole (IS), and end systole (ES). Wall thickening (delta t) for each segment was calculated as the percent increase in thickness from ED and averaged for all seven patients. At the apex level before resection, isovolumetric thinning occurred in the aneurysm as well as bordering segments, with delta t ranging from -17 +/- 5% (+/- SEM) in the anteroseptal segment to 12 +/- 6% posterolaterally (p less than 0.05). The isovolumetric bulge was followed by late-systolic thickening, however, with delta t ranging from 13 +/- 7% to 27 +/- 8% (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Author List
Nicolosi AC, Spotnitz HMMESH terms used to index this publication - Major topics in bold
AdultAged
Echocardiography
Heart Aneurysm
Humans
Intraoperative Care
Middle Aged
Myocardial Contraction
Myocardial Infarction
