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Autopsy findings in early and late postoperative death after partial left ventriculectomy.

Authors :
Cury PM
Higuchi ML
Gutierrez PS
Moreira LF
Bocchi EA
Stolf NA
Jatene AD
Source :
The Annals of thoracic surgery [Ann Thorac Surg] 2000 Mar; Vol. 69 (3), pp. 769-73.
Publication Year :
2000

Abstract

Background: Partial left ventriculectomy (PLV) is an alternative to heart transplantation for patients with severe heart failure. However, this procedure is accompanied by high morbidity and mortality. Therefore, we studied the hearts of 12 patients who underwent this procedure to increase our understanding of the causes of bad outcome.<br />Methods: We analyzed the autopsy hearts of 11 of 16 patients who died after PLV, and one heart from a patient who underwent heart transplantation.<br />Results: Six patients died less than 30 days postoperatively, 4 of cardiogenic shock, 1 of arrhythmia, and 1 of coagulopathy. Five patients died from 36 to 120 days after the procedure, 4 of cardiogenic shock and 1 of arrhythmia. The patient who underwent heart transplantation had a cardiogenic shock 230 days after PLV. Ten hearts weighed more than 500 g and nine had myocardial infarction that extended to the papillary muscles. Four patients had infarction of both papillary muscles and 3 of them had episodes of arrhythmia, suggesting some relation between these events.<br />Conclusions: We found several important morphologic clues for bad outcome: infarction of both papillary muscles, which may be associated with the development of arrhythmia, and myocardial infarction and pericardial hemorrhage, which may contribute to the outcome of heart failure.

Details

Language :
English
ISSN :
0003-4975
Volume :
69
Issue :
3
Database :
MEDLINE
Journal :
The Annals of thoracic surgery
Publication Type :
Academic Journal
Accession number :
10750759
Full Text :
https://doi.org/10.1016/s0003-4975(99)01365-x