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PredicateObject
rdf:type
lifeskim:mentions
pubmed:dateCreated
2004-4-13
pubmed:abstractText
The aim of our study was to evaluate patients survival, changes of functional status after repair of ischemic mitral insufficiency and coronary artery bypass grafting in acute period of myocardial infarction. In the Clinic of Cardiosurgery of Kaunas University of Medicine (since January 2001 till July 2003) 82 patients with acute myocardial infarction underwent surgery. Patients were operated on the 1(st)-21(st) day after myocardial infarction. Among 82 operated patients with acute myocardial infarction, 64 (78%) underwent coronary artery bypass grafting and 18 (22%) - coronary artery bypass grafting with mitral valve repair. Ten patients (55.6%) were in NYHA functional class II and 44.4% - in NYHA functional class III. Before myocardial infarction ischemic heart disease was diagnosed in 12 (66.7%) patients; 8 (44.4%) patients had a history of myocardial infarction. Patients were not operated during the first 24 hours of myocardial infarction. All patients were evaluated by means of 2 Doppler-echocardiography and transesophageal echocardiography before, during and a few days after operation. Eighteen patients underwent mitral valve repair: in 9 (50%) - annulocompression (original technique), in 7 (39%) - annulocompression with shortening of papillary muscles, in 1 case - Kay valvuloplasty was performed. One patient needed mechanical mitral valve prosthesis due to rheumatic mitral valve disease. After correction of ischemic mitral incompetence improvement of left ventricular function was observed. Medial-lateral mitral valve ring diameter was reduced from 36.8+/-2.6 mm to 23.9+/-0.56 mm (p<0.01) resulting in decrease of degree of mitral incompetence - 2.9+/-0.2 to 0.7+/-0.8, mean LVEDD - 53.3+/-6 to 50+/-4.1 mm, improvement of LVEF - 35.9+/-6.3 to 38.4+/-9.5, LVWSI from 2.61+/-0.22 to 1.81+/-0.43. CONCLUSIONS: 1. Patients suffering acute myocardial infarction with >II degrees mitral valve incompetence, should receive coronary artery bypass grafting with mitral valve repair. 2. Repair of ischemic mitral incompetence should consist of annulocompression with/without papillary muscle shortening. 3. Early results surgery in patients with acute myocardial infarction and mitral valve incompetence are similar to the results of surgery on stable ischemic heart disease with mitral valve incompetence if operation is performed on the 3(rd) day of acute myocardial infarction.
pubmed:language
lit
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
1648-9144
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
40 Suppl 1
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
70-4
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
2004
pubmed:articleTitle
[Myocardial revascularization and mitral insufficiency correction in case of acute myocardial infarction].
pubmed:affiliation
Clinic of Cardiosurgery, Heart Center, Kaunas University of Medicine, Institute for Biomedical Research, Lithuania. Sakalauskas_J@hotmail.com
pubmed:publicationType
Journal Article, English Abstract