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首页> 外文期刊>Journal of cardiac surgery. >Partial left ventriculectomy: overall and late results in 44 class IV patients with 4-year follow-up.
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Partial left ventriculectomy: overall and late results in 44 class IV patients with 4-year follow-up.

机译：左室部分切除术：44例IV级患者的总体和晚期结果，随访4年。

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BACKGROUND: This study reports long-term results of partial left ventriculectomy (PLV). METHODS: Forty-four patients with dilated cardiomyopathy were operated on in a 4-year study. Echocardiograms, catheterization, and stress tests with oxygen consumption (VO2) were performed. RESULTS: The survivors' preoperative ejection fractions of 22.1% +/- 4.9% improved to 30.9% +/- 9.4%, left ventricular (LV) end-diastolic diameter decreased from 79.4 +/- 9.3 mm to 61.9 +/- 8.2 mm, and maximum VO2 consumption improved from 8.8 +/- 3.9 mL/kg per minute to 15.8 +/- 6.1 mL/kg per minute at 22.6 months. These data also showed improvements in nonsurviving patients, according to the last evaluation before death. Seven of 12 survivors (58.3%) were in New York Heart Association (NYHA) I and II in December 1998. Twelve patients had elevated pulmonary vascular resistance (PVR) contraindicating heart transplant. In five patients the PVR returned to normal and one high-PVR patient was transplanted at the 16th postoperative month. Survival was 56.8%, 47.7%, 38.4%, and 35.9%, respectively, at 3, 6, 12, and 18 months, with a tendency to stabilize at 32.7% thereafter. Arrhythmias and heart failure were the main causes of death. CONCLUSIONS: In spite of improvement of ventricular function and quality of life of the survivors, high mortality is a limiting factor. PLV can be indicated as a bridge to heart transplantation in high-PVR patients or if ventricular assist devices or donor hearts are not available.
机译：背景：这项研究报告了部分左心室切除术（PLV）的长期结果。方法：一项为期4年的研究对44例扩张型心肌病患者进行了手术。进行了超声心动图，导管插入术以及带有耗氧量（VO2）的压力测试。结果：幸存者的术前射血分数由22.1％+/- 4.9％提高至30.9％+/- 9.4％，左心室（LV）舒张末期直径从79.4 +/- 9.3毫米降低至61.9 +/- 8.2毫米，在22.6个月时，最大的VO2消耗量从每分钟8.8 +/- 3.9毫升/千克提高到了每分钟15.8 +/- 6.1毫升/千克。根据死亡前的最新评估，这些数据还显示了未存活患者的改善。 1998年12月，12名幸存者中有7名（58.3％）在纽约心脏协会（NYHA）I和II中。12名患者的肺血管阻力（PVR）升高，提示心脏移植无效。在五名患者中，PVR恢复正常，并且在术后第16个月移植了一名高PVR患者。在第3、6、12和18个月的生存率分别为56.8％，47.7％，38.4％和35.9％，此后趋于稳定在32.7％。心律不齐和心力衰竭是死亡的主要原因。结论：尽管改善了心室功能和幸存者的生活质量，高死亡率仍是一个限制因素。 PLV可以指示为高PVR患者或如果没有心室辅助设备或供体心脏时心脏移植的桥梁。

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