Correlation between plasma N-terminal probrain natriuretic peptide levels and changes in New York Heart Association functional class, left atrial size, left ventricular size and function after mitral and/or aortic valve replacement

Records of 103 patients with constrictive pericarditis who underwent subtotal pericardiectomy from January 1990 to December 1997 were retrospectively analyzed. The etiology of pericardial constriction was unknown in 63, tuberculous in 30, pyogenic in 7, and miscellaneous in 3 patients. Adequate pericardiectomy could be accomplished in 85 (82.5%) patients. Eleven patients (10.68%) died within 30 days of surgery. The 92 survivors were followed up for 47.21 ± 30.7 months; functional status improved in all cases. Of 15 variables examined by univariate logistic regression analysis, preoperative New York Heart Association functional class IV, atrial fibrillation, left atrial size > 40 mm·m−2, mild to moderate mitral regurgitation, tricuspid regurgitation, pericardial calcification, and inadequate pericardiectomy were found to be significant predictors of poor outcome. Adequate pericardiectomy via sternotomy was considered to carry low operative risk and provide excellent improvement in functional capacity.

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No Correlation Between Atrial Natriuretic Peptide Concentrations and Echocardiographic Measurements of Left Atrial Size or Left Ventricular Size and Function in Patients with Persistent Atrial Fibrillation

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.2005.00009.x ◽

2005 ◽

Vol 28 (s1) ◽

pp. S110-S114 ◽

Cited By ~ 4

Author(s):

BEATA WOŻAKOWSKA-KAPLON ◽

GRZEGORZ OPOLSKI

Keyword(s):

Atrial Fibrillation ◽

Atrial Natriuretic Peptide ◽

Natriuretic Peptide ◽

Left Atrial ◽

Persistent Atrial Fibrillation ◽

Left Ventricular ◽

Ventricular Size ◽

Left Atrial Size ◽

Atrial Size ◽

And Function

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An Early Canadian Experience with the Correx Automated Coring and Apical Connector Device for Aortic Valve Bypass

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000322 ◽

2016 ◽

Vol 11 (6) ◽

pp. 434-438

Author(s):

Hussein A. Al-Amodi ◽

Christopher L. Tarola ◽

Hamad F. Alhabib ◽

Corey Adams ◽

Linrui Ray Guo ◽

...

Keyword(s):

New York ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Heart Association ◽

Left Ventricular ◽

Functional Class ◽

New York Heart Association ◽

Apical Connector ◽

Aortic Valve Bypass

Objective Aortic valve replacement is the standard of care for severe, symptomatic aortic valve stenosis (AS); however, anatomy or preexisting comorbidities may preclude conventional or alternative transcatheter approaches. Aortic valve bypass (AVB) may be performed as a salvage procedure for the relief of symptomatic aortic stenosis in patients who are not suitable candidates for aortic valve replacement. Methods At our institution, seven patients underwent AVB using the Correx automated coring and apical connector system. All patients had severe AS with New York Heart Association functional class 3 symptoms and were not candidates for conventional or transcatheter approaches. Via a left anterolateral thoracotomy to access the descending aorta and left ventricular apex, we used the Correx system (Correx, Waltham, MA USA) to anastomose a valve conduit to the left ventricular apex proximally and the descending aorta distally. Three patients required cardiopulmonary bypass. Results In all seven patients, the automated coring and apical connector was successfully deployed. There were two in-hospital deaths in this series. Immediately postoperatively and at 3 months, there was a significant reduction in mean and peak valve gradients, and all surviving patients performed at New York Heart Association functional class 1. Conclusions Aortic valve bypass seems to be an acceptable alternative for the treatment of severe AS in high-risk patients who are not candidates for aortic valve replacement. The Correx automated system may improve the clinical applicability and surgical repro-ducibility of AVB in appropriately selected patients in which conventional or transcatheter aortic valve replacement is not a feasible options.

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Real-Time Three-Dimensional Echocardiographic Study of Left Ventricular Function After Infarct Exclusion Surgery for Ischemic Cardiomyopathy

Circulation ◽

10.1161/circ.102.suppl_3.iii-101 ◽

2000 ◽

Vol 102 (suppl_3) ◽

Author(s):

Jian Xin Qin ◽

Takahiro Shiota ◽

Patrick M. McCarthy ◽

Michael S. Firstenberg ◽

Neil L. Greenberg ◽

...

Keyword(s):

New York ◽

Ischemic Cardiomyopathy ◽

Heart Association ◽

Left Ventricular ◽

Functional Class ◽

Before And After ◽

Infarct Exclusion ◽

New York Heart Association ◽

Lv Volume

Background —Infarct exclusion (IE) surgery, a technique of left ventricular (LV) reconstruction for dyskinetic or akinetic LV segments in patients with ischemic cardiomyopathy, requires accurate volume quantification to determine the impact of surgery due to complicated geometric changes. Methods and Results —Thirty patients who underwent IE (mean age 61±8 years, 73% men) had epicardial real-time 3-dimensional echocardiographic (RT3DE) studies performed before and after IE. RT3DE follow-up was performed transthoracically 42±67 days after surgery in 22 patients. Repeated measures ANOVA was used to compare the values before and after IE surgery and at follow-up. Significant decreases in LV end-diastolic (EDVI) and end-systolic (ESVI) volume indices were apparent immediately after IE and in follow-up (EDVI 99±40, 67±26, and 71±31 mL/m 2 , respectively; ESVI 72±37, 40±21, and 42±22 mL/m 2 , respectively; P <0.05). LV ejection fraction increased significantly and remained higher (0.29±0.11, 0.43±0.13, and 0.42±0.09, respectively, P <0.05). Forward stroke volume in 16 patients with preoperative mitral regurgitation significantly improved after IE and in follow-up (22±12, 53±24, and 58±21 mL, respectively, P <0.005). New York Heart Association functional class at an average 285±144 days of clinical follow-up significantly improved from 3.0±0.8 to 1.8±0.8 ( P <0.0001). Smaller end-diastolic and end-systolic volumes measured with RT3DE immediately after IE were closely related to improvement in New York Heart Association functional class at clinical follow-up (Spearman’s ρ=0.58 and 0.60, respectively). Conclusions —RT3DE can be used to quantitatively assess changes in LV volume and function after complicated LV reconstruction. Decreased LV volume and increased ejection fraction imply a reduction in LV wall stress after IE surgery and are predictive of symptomatic improvement.

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Cardiac resynchronization therapy for ischemic myopathy

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492316652056 ◽

2016 ◽

Vol 25 (5) ◽

pp. 383-385

Author(s):

Shinichiro Ikeda ◽

Hideo Yoshida ◽

Keiji Yunoki ◽

Kunikazu Hisamochi

Keyword(s):

New York ◽

Cardiac Resynchronization Therapy ◽

Heart Association ◽

Left Ventricular ◽

Functional Class ◽

Cardiac Resynchronization ◽

Resynchronization Therapy ◽

Mitral Valve Plasty ◽

New York Heart Association ◽

The Right

We performed coronary artery grafting, mitral valve plasty, and tricuspid plasty in a 75-year-old man who had double-vessel coronary disease and moderate mitral and tricuspid insufficiency. Preoperative transthoracic echocardiography revealed an ejection fraction of 34% and dyssynchronous wall motion of the septum and free wall. We placed pacing leads on the right ventricular outlet and posterior left ventricular wall for cardiac resynchronization therapy. The dyssynchrony disappeared postoperatively and the New York Heart Association functional class improved from IV to I.

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Unusual Left Ventricular Function and Survival in Peripartum Cardiomyopathy

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230000800215 ◽

2000 ◽

Vol 8 (2) ◽

pp. 155-157

Author(s):

Mandeep Bhargava ◽

Mandeep Singh ◽

Pujar Venkateshacharya Suresh ◽

Rajneesh Juneja ◽

Harinder Kumar Bali ◽

...

Keyword(s):

New York ◽

Enzyme Inhibitors ◽

Heart Association ◽

Angiotensin Converting Enzyme Inhibitors ◽

Left Ventricular ◽

Functional Class ◽

Peripartum Cardiomyopathy ◽

Class Iii ◽

Converting Enzyme Inhibitors ◽

New York Heart Association

A 34-year-old woman presented with congestive heart failure 3 months after her third pregnancy. She was stabilized in New York Heart Association functional class II with digoxin and diuretics for 21 years. She was readmitted with worsening symptoms and found to have a regional contraction abnormality. With the addition of angiotensin-converting enzyme inhibitors to her medication, she has been maintained in functional class III for a further 4 years.

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Cardiac recovery following left ventricular assist device therapy: experience of complete device explantation including ventricular patch plasty

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa461 ◽

2020 ◽

Author(s):

Takayuki Gyoten ◽

Sebastian V Rojas ◽

Henrik Fox ◽

Masatoshi Hata ◽

Marcus-André Deutsch ◽

...

Keyword(s):

New York ◽

Ventricular Assist Device ◽

Heart Association ◽

Left Ventricular ◽

Functional Class ◽

Myocardial Recovery ◽

Assist Device ◽

Ventricular Assist ◽

New York Heart Association ◽

Patch Plasty

Abstract OBJECTIVES Myocardial recovery is a rare phenomenon in left ventricular assist device (LVAD) therapy. Surgical LVAD removal is associated with the risk of cardiac failure, and the individual evaluation of sufficient myocardial recovery is crucial. Thus, complete device explantation is not consistently performed to minimize perioperative risk. However, the remaining ventricular assist device components bear significant risks of infection or thrombosis. Therefore, we developed this study to evaluate a complete LVAD explantation protocol. METHODS All patients in our institution who had an LVAD explanted were enrolled in the study. Explant surgery involved removal of the driveline, pump housing, sewing ring and outflow graft. The ventricular wall was reconstructed by double patch plasty. Our analysis focused on surgical and postoperative outcome parameters, including all-cause mortality and major adverse cardiac and cerebrovascular events. RESULTS A total of 12 patients (HVAD, n = 5; HeartMate II, n = 3; HeartMate 3, n = 4) had myocardial recovery and qualified for our LVAD explantation study protocol [median age: 40 years, interquartile range (IQR) 33–52 years; 50% men]. Primary heart failure aetiology: myocarditis (n = 5), dilated cardiomyopathy (n = 4), toxic cardiomyopathy (n = 2) and valvular heart failure (n = 1). The median average duration on LVAD was 10 months (25–75%: IQR 8.5–30 months). The median left ventricular ejection fraction was 15% (IQR 13–18%) at LVAD implantation and 50% (IQR 45–50%) before LVAD explantation (P = 0.0025).The 30-day survival was 100%. The 1-year survival was 91.7%. All patients were discharged after a median 13 days (IQR 10–18 days) postoperatively. No patient had major adverse cardiac and cerebrovascular events. The New York Heart Association functional class remained consistent during the follow-up period (median New York Heart Association functional class: II, IQR II–II class) including preservation of ventricular function. CONCLUSIONS Complete LVAD explantation with ventricular patch plasty is feasible and has consistent long-term results.

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