Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Результаты хирургического лечения постинфарктного ремоделирования левого желудочка

Abstract

Introduction. The problem of reconstructive surgeries need in the patients with left ventricle postinfarction remodeling (LVPR) is still not solved. Results of reconstructive surgeries on LV depending on basic type of postinfarction remodeling, availability of diastolic dysfunction are studied in this prospective investigation. Material and methods. The objective of the investigation was 112 patients with ischemic heart disease (IHD) who underwent one or more myocardial infarctions with left ventricle ejection fraction (LV EF) less than 46%. In the first group there were patients with I type of postinfarction remodeling (n=29). Selection criteria to the second group were II and III type M. Di Donato remodeling (n=83). Reconstructive surgeries on LV cavity were performed in all the patients fr om the first group. Stratified randomization was carried out in the patients from the second group. The patient had also coronary artery bypass grafting (n=34) or coronary artery bypass grafting associated with LV reconstruction (n=49). Results. LV remodeling process continues in case of refusal to perform reconstruction of LV cavity for the patients with the II type in the late postoperative period. Statistically significant difference with respect to all factors was not revealed during comparison of surgical results of its cavity with isolated revascularization in the patients with the III type of postinfarction remodeling. Progressive remodeling after LV reconstruction was noted in 22.7% patients. In 11.4% of patients stroke index (SI) was within normal lim its,

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