scholarly journals The arch-like plasty of the left atrium in correction of a mitral valve failure

2021 ◽  
Vol 88 (5-6) ◽  
pp. 18-22
Author(s):  
V. V. Popov ◽  
A. A. Bolshak ◽  
V. V. Lazoryshynets
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Sinus Rhythm ◽  
Left Atrium ◽  
Main Group ◽  
Left Ventricle Ejection Fraction ◽  
Control Group ◽  
Group 2 ◽  
Cardio Vascular

Objective. Studying the possibilities of the method of the left atrium arch-like plasty while correcting of a mitral failure in combination with the left atrium dilatation. Materials and methods. Into the analysis of the surgical treatment results in 190 patients, suffering mitral failure in combination with the left atrium dilatation, who were operated in the National Institute of Cardio-Vascular Surgery named after N. M. Amosov NAMS of Ukraine in a period from 01.01.2012 to 01.01.2021 yr, were included. The main group consisted of 103 patients, to whom correction of a mitral failure in combination with original procedure of the arch-like plasty of left atrium was performed. Into a control group 87 patients were included, to whom the correction of a mitral valve failure was done without concomitant plasty of left atrium. Results. Of 103 operated patients of the main group on the hospital stage 1 have died (0.9% lethality). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of the left ventricle - (63.1 ± 11.3) ml/m2 (preoperatively), (58.3 ± 8.4) ml/m2 (postoperatively), (49.4 ± 9.2) ml/m2 (remote period); the left ventricle ejection fraction: 0.52 ± 0.04 (preoperatively), 0.55 ± 0.04 (postoperatively), 0.57 ± 0.03 (remote period). Diameter of left atrium: (58.8 ± 6.4) mm (preoperatively), (41.4 ± 5.3) mm (postoperatively), (43.9 ± 2.3) mm (remote period). Sinus rhythm in a remote period was stable in 75 (78.9%) of 95 patients. Of 87 operated patients of a control group 2 died (lethality 2.3%). Dynamics of the echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle- (67.3 ± 11.3) ml/m2 (preoperatively), (60.4 ± 9.3) ml/m2 (postoperatively), (52.7 ± 7.2) ml/m2 (remote period); the left ventricle ejection fraction: 0.52 ± 0.05 (preoperatively), 0.54 ± 0.05 (postoperatively), 0.54 ± 0.03 (remote period). Diameter of left atrium: (59.5 ± 2.3) mm (preoperatively), (57.5 ± 3.7) mm (postoperatively), (68.5 ± 3.4) mm (in remote period). Sinus rhythm was stable in 18 (22.5%) of 80 patients, followed in the remote period. Conclusion. The arch-like plasty of left atrium is a low-traumatic and effective procedure, leading to significant improvement of the left atrium morphometry and accompanied by low risk for postoperative lethality.

scholarly journals Triangular plasty of left atrium in correction of mitral failure

2021 ◽  
Vol 88 (3-4) ◽  
pp. 3-7
Author(s):  
V. V. Popov ◽  
A. A. Bolshak ◽  
V. Zh. Boukarim
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Left Atrium ◽  
Main Group ◽  
Left Ventricle Ejection Fraction ◽  
Control Group ◽  
Late Period ◽  
Original Procedure ◽  
Group 3 ◽  
Left Atrium Diameter

Objective. Studying of possibilities of procedure of the left atrium triangular plasty while doing correction of mitral failure, coexisted with left atriomegaly. Materials and methods. There were analyzed results of surgical treatment of 330 patients, suffering mitral failure in combination with left atriomegaly, who were operated in Amosov National Institute of Cardiovascular Surgery in period from 1 Jan 2005 to 1 Jan 2021 yr. The main group have consisted of 143 patients, to whom correction of mitral failure together with original procedure of triangular plasty of left atrium was performed. The control group have consisted of 187 patients, to whom correction of mitral failure was done only, although they suffered concurrent left atriomegaly. Results. Of 143 patients operated in the main group 3 died (lethality have constituted 2.1%). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle – (69.1 ± 12.1) ml/m2 before the operation, (59.3 ± 8.5) ml/m2 postoperatively, (48.4 ± 9.5) ml/m2 in late period; the left ventricle ejection fraction – 0.51 ± 0.05 preoperatively, 0.54 ± 0.05 postoperatively 0.56 ± 0.04 in late period. The left atrium diameter dynamics was following: (65.8 ± 4.1) mm preoperatively, (52.3 ± 2.1) mm postoperatively, and (53.5 ± 2.2) mm in late period. Of 187 оperated patients of control group 6 have died, (lethality have constituted 3.2%). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle – (68.3 ± 11.3) ml/m2 before the operation, (60.4 ± 9.3) ml/m2 postoperatively, (52.7 ± 7.2) ml/m2 in late period; the left ventricle ejection fraction – 0.52 ± 0.05 preoperatively, 0.53 ± 0.05 postoperatively, 0.5 ± 0.04 in late period. Diameter of left atrium: (66.5 ± 3.7) mm preoperatively, (63.5 ± 2.3) mm postoperatively, (71.5 ± 2.4) mm in late period. Conclusion. Triangular plasty of left atrium is a low-traumatic and effective procedure, leading to significant improvement in its morphometry and accompanied by low risk of hospital lethality.

scholarly journals Triangular plasty of left atrium in a left-sided atriomegaly

2020 ◽  
Vol 87 (5-6) ◽  
pp. 26-29
Author(s):  
V. Zh. Boukarim ◽  
A. A. Bolshak ◽  
V. V. Popov
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Blood Circulation ◽  
Cardiovascular Surgery ◽  
Main Group ◽  
Control Group ◽  
Thromboembolic Complications ◽  
The Brain ◽  
Left Atrium Diameter

Objective. Studying possibilities of the triangular plasty of left atrium procedure, performed while prosthesis of a mitral valve. Materials and metods. Into the main group 137 patients, suffering isolated mitral failure, complicated by left atriomegaly (diameter of left atrium ≥ 6.0 cм), to whom surgical treatment was performed in Amosov National Institute of Cardiovascular Surgery from 01.10.2010 to 01.01.2019 yr, were included. In all the patients a prosthesis of a mitral valve, preserving native structures of a mitral valve with reduction of the left atrium cavity, using procedure of the left atrium triangular plasty, was performed. Into a control group were included 57 patients, in whom a mitral valve correction without a left atrium reduction was performed only for a mitral valve failure and a left-sided atriomegaly (diameter of left atrium was ≥ 6.0 cm). Results. Of 137 patients of the main group on the hospital stage 3 (2.2%) have died. Dynamics of echocardiographic indices of the left atrium diameter on different stages was following: (65.5 ± 3.8) mm preoperatively, (51.5 ± 2.1) mm postoperatively, (52.5 ± 2.2) mm in a remote follow-up period, in a remote follow-up period in (5.1 ± 0.4) years at average, thromboembolic complications (the transient disorders of the brain blood circulation) were noted in (1.6%) of 125 patients. Of 57 patients of a control group on the hospital stage 2 (3.5%) have died. Dynamics of echocardiographic indices, concerning diameter of the left atrium on various stages was following: (66.7 ± 2.7) mm preoperatively, (63.5 ± 2.3) mm postoperatively, (71.5 ± 2.4) mm in the remote follow-up period. In the remote follow-up period in (7.1 ± 0.4) years, thromboembolic complications were noted in 7 (14.6%) of 48 patients. Conclusion. The procedure of triangular plasty of left atrium constitutes an obligatory stage while performing correction of a mitral failure in presence of a left-sided atriomegaly (diameter of left atrium ≥ 6.0 cm). The procedure is miniinvasive and effective, leads to significant improvement of the left atrium morphometry and is accompanied by low risk of the complications occurrence and hospital mortality. The data accumulated and estimation of remote results of the procedure permits her to occupy a significant place among other methods of atrioplasty.

scholarly journals P308 Changes in the echocardiographic phenotype during the evolution of cardiac amyloidosis from preserved to reduced left ventricle ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V Faga ◽  
V Mora Llabata ◽  
I Roldan Torres ◽  
A Saad ◽  
A M Cuevas Vilaplana ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Speckle Tracking ◽  
Cardiac Amyloidosis ◽  
Speckle Tracking Echocardiography ◽  
Radial Strain ◽  
Left Ventricle Ejection Fraction ◽  
Control Group ◽  
P Value ◽  
2D Speckle Tracking

Abstract Introduction Cardiomyopaties like Cardiac Amyloidosis (CA), are an important cause of Heart Failure (HF). They can cause endocardial or transmural involvement. It is possible to characterize the kind of affectation thanks to different phenotypes identified by 2D speckle tracking echocardiography. Purpose: To study the pattern of myocardial involvement in patients (p) affected by CA and HF. Methods: Comparative study of 30 p with CA and HF, in NYHA class ≥II/IV, of which 16 had preseved left ventricle ejection fraction (pLVEF) and 14 had reduced LVEF (rLVEF), considering as cut point a LVEF > 50%. There was a control group (CG) of 16 healthy subjects. Twist, radial strain (RS), circunferential strain (CS) and longitudinal strain (LS) were determined using 2D speckle-tracking echocardiography, along with mitral annulus plane systolic excursion (MAPSE) and basal-apex distance (B-A). The following indexes were calculated: Twist (apical rotation + basal rotation, °); Torsion (twist/B-A, °/cm); Torsion Index (TorI: twist/MAPSE, °/cm), and Deformation Index (DefI:twist/LS,°). The last indexes are dynamic parameters that allow for a more realistic assessment of LV torsion, since they include longitudinal shortening measures such as MAPSE and LS, describing in a more complete and physiological way the global LV systolic movement. Results There were differences of age between the three gropus, being older the p with rLVEF and younger the ones in the CG (63,7 ± 2,8; 68,2 ± 11,5; y 73,9 ± 12,9 years respectively). LS and CS were lower in rLVEF group when compared with pLVEF group, as well as in pLVEF group compared with the CG. The p with pLVEF showed increased values of the dynamic torsion parameters (DefI and TorI), indicating a compensatory increase of LV twist that disappears in p with rLVEF. Twist and Torsion are significantly lower only in the rLVEF group (see table). Conclusions In both CA groups, LS and CS deterioration indicates endocardial and transmural involvement. The loss of compensation given by the increased LV twist, reflected by DefI and TorI, marks the transition to the deterioration of LVEF. Results Table LVEF (%) LS (%) CS (%) TWIST (°) Torsion (°/cm) TorI (°/cm) DefI (°/%) Control Group (n = 15) 68.2 ± 6.3 -20.6 ± 2.5 -22.7 ± 4.9 21.7 ± 6.1 2.7± 0.8 16.4 ± 4.7 -1.0 ± 0.3 CA pLVEF (n = 16) 60,6 ± 5.4* -11.7 ± 4.2* -17.2 ± 4.8* 19.8 ± 8.3 2.5± 1.1 27.7 ±13.5* -1.8 ± 0.9* CA rLVEF (n = 14) 37.2 ± 8.8** -8.7 ± 3.2** -13.0 ± 3.4** 8.3 ± 5.6** 1.0 ± 1.7** 13.4 ± 9.6** -1.0 ± 0.7** *:p value <0,01 between CG and pLVEF group; **:p value <0,01 between pLVEF and rLVEF

P1490Exercise lung ultrasound in patients with exertional dyspnea: pilot study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Malek ◽  
J Vecera ◽  
M Kubrycht ◽  
J Matejka ◽  
P Vojtisek
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Left Atrium ◽  
Lung Ultrasound ◽  
Left Ventricle Ejection Fraction ◽  
Exertional Dyspnea ◽  
Echocardiographic Parameters ◽  
Study Population ◽  
Left Atrium Diameter ◽  
B Lines

Abstract Purpose The aim of the present study was to test the correlation of the exercise lung ultrasound (LUS) and B-lines count with clinical, laboratory and echocardiographic parameters among patients with preserved left ventricle ejection fraction and without signs of congestion reffered for cardiopulmonary exercise test (CPET) for exertional dyspnea. Methods The study population consisted of 39 patients (age 63.0±9.3 years; 62% females) with preserved ejection fraction (≥50%) and without signs of congestion reffered for exercise testing. Pulmonary disease and coronary artery disease was ruled out. CPET, rest and stress echocardiography and B-lines count assessed by 8 zone LUS were performed. Results Exercise B-lines count was significantly higher than rest B-lines count (3.1±0.5 vs. 1.1±0.2; p<0.001). No correlation was found between B-lines count and peakVO2, workload, NT-proBNP. Among echocardiographic parameters only left atrium diameter correlated weakly (r=0.35; p=0.027) with exercise B-lines count. Difference between rest and exercise B-lines count correlated weakly with VE/VCO2 (r=0.41; p=0.015). Characteristics of study population <3 B-lines (n=22) ≥3 B-lines (n=17) p Age (years) 62.2±6.2 64.1±12.1 NS Females (n; %) 16 (72.7%) 8 (47.1%) NS DM (n; %) 3 (14%) 1 (6%) NS Arterial hypertension (n; %) 15 (68%) 14 (82%) NS BMI (kg/m2) 29.4±5.7 31.3±3.3 NS NYHA class 1.9±0.5 2.0±0.4 NS HFpEF (n; %) 8 (57.1%) 8 (42.1%) NS NT-proBNP (pg/ml) 240.0±472.8 275.4±323.1 NS E/e' 9.8±2.7 10.4±2.2 NS Left atrial diameter (mm) 36.4±4.7 39.4±4.6 p=0.039 LVEF (%) 62.9±5.6 60.6±4.7 NS PeakVO2 (ml/kg/min) 20.2±5.7 19.5±3.6 NS VE/VCO2 32.3±5.7 35.9±6.2 NS WR (W/kg) 1.7±0.5 1.5±0.3 NS DM = diabetes mellitus; LVEF = left ventricle ejection fraction; WR = workload. Rest and peak exercise B-lines count Conclusion We observed weak but significant correlation between exercise B-lines count and left atrium diameter. However we didn't observe significant difference between HFpEF patients and rest of study population in B-lines count. Limitation of our observation is small study population.

P1762Prognostic significance of in-hospital incomplete and terminated revascularization in patients with acute myocardial infarction and without reduced left ventricle ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Francuz ◽  
T Podolecki ◽  
M Mazurek ◽  
L Wloch ◽  
A Swiatkowski ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Cox Regression ◽  
Myocardial Revascularization ◽  
Left Ventricle Ejection Fraction ◽  
Risk Of Death ◽  
Group 2 ◽  
Group 1

Abstract Introduction In-hospital incomplete and terminated at discharge myocardial revascularization has significant impact on mortality after acute myocardial infarction (AMI), also in patients (pts) with reduced left ventricle ejection fraction (LVEF) ≤35%. However, subjects with LVEF >35%, who are not candidates for implantable cardioverter defibrillators, are still at risk. Authors hypothesized, that in those pts, the prognosis could be related to completeness of revascularization. Purpose To evaluate the risk of death and major adverse cardiovascular events (MACE) among pts with AMI and LVEF>35% in relation to myocardial revascularization status. Methods Single center prospective study encompassed 445-pts with AMI and LVEF>35%, who were treated with percutaneous coronary intervention and who survived in-hospital period. Study population was divided into two groups: group 1. – 73-pts with in-hospital incomplete and terminated revascularization at discharge; group 2. – 372-pts with complete or incomplete revascularization, in whom scheduled procedures were planned and performed (either percutaneous or surgical). The incidence of death and MACE was compared between groups during mean follow-up of 47.5 months after AMI. MACE was defined as a composite of death, recurrent AMI, non-scheduled revascularization, acute heart failure, stroke. Independent predictors for death were identified with multivariate Cox-regression models and expressed as hazard ratio (HR) with 95% confidence interval (CI). Results Patients in group 1. had higher mortality rate than in group 2. (26.4% vs. 9.1%; p<0.001) – figure 1. The difference in the incidence of MACE was higher in group 1. than in group 2. (59.7% vs. 28.2%; p<0.001). The analysis of particular MACE showed, that in group 1. the incidence of recurrent AMI, non-scheduled revascularization and stroke was higher than in group 2. (17.8% vs. 8.9%; p=0.022, and 33.3% vs. 16.1%; p=0.001, and 6.8% vs. 2.4%; p=0.048, respectively). Independent risk factors for death were: age ≥65 years (HR: 4.2; CI: 2.1–8.0) and incomplete and terminated myocardial revascularization at hospital discharge (HR: 2.5; CI: 1.4–4.4). Conclusions After invasive treatment of AMI, the prognosis in patients with LVEF>35% is related to revascularization status. In-hospital incomplete and terminated revascularization at discharge is an independent risk factor for death in this population.

scholarly journals Left ventricle ejection fraction may predict mortality in renal transplant patients

Renal Failure ◽  
2016 ◽  
Vol 38 (10) ◽  
pp. 1622-1625 ◽  
Author(s):  
Faruk Ozkul ◽  
Muhammmet Kasim Arik ◽  
Halil Erbiş ◽  
Alpaslan Akbaş ◽  
Vural Taner Yilmaz ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Left Ventricle Ejection Fraction ◽  
Transplant Patients ◽  
Renal Transplant Patients
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