Jansen, W.M. (2021) Patients with Left Ventricular Aneurysm Receiving Surgical Ventricular Reconstruction Using Autologous Endocardium have Comparable Long-Term Follow-Up Results Compared to Current Common Practice. thesis, Medicine.
Full text available on request.Abstract
Objectives: Left ventricular aneurysm (LVA) formation is a severe complication after transmural myocardial infarction (MI). Over the last 60 years, different surgical ventricular reconstruction (SVR) techniques have been developed, but there still is no clear consensus about the most appropriate technique. This study analyzed the short and long-term outcomes of a new SVR technique by using autologous endocardium compared to other more commonly practiced techniques (e.g. plication, patch). Methods: We retrospectively reviewed 95 patients receiving SVR due to a LVA between 2005 and 2019 in Medisch Spectrum Twente, department of cardiothoracic surgery. Patients either received on-pump beating heart endoventriculoplasty using autologous endocardium (Grandjean) or a more commonly used technique (e.g. patch, plication). The early surgical outcomes, long-term survival and resulting cardiac function were compared. Results: Mean age of patients was 67 years. Pre-operative left ventricular ejection fraction (LVEF) was 33% [22 – 40%]. 55% of the patients had NYHA classification of III/IV. No significant difference in in-hospital mortality or in-hospital complications was found. 1, 3 and 5-year mean postoperative LVEF in the autologous group were 40%, 43% and 36% compared to 45%, 44% and 39% in the other group, no significant difference was found between the groups (p = 0.21). 1, 5 and 10 year survival rates were 93%, 62% and 24%, respectively. Conclusion: The new SVR technique, by using autologous endocardium, shows similar good results regarding operative complications and survival compared to longer existing SVR techniques. Surgical technique should be chosen based on patient and aneurysm characteristics.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Grandjean, prof. dr. J.G. and Halfwerk, dr. F.R. |
| Faculty: | Medical Sciences |
| Date Deposited: | 03 Jan 2022 11:14 |
| Last Modified: | 03 Jan 2022 11:14 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2924 |
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