Preoperative modeling of an optimal left ventricle volume for surgical treatment of XXXX .

@entity1 @entity64 @entity439
OBJECTIVE: We evaluated the results of surgical treatment postinfarction @entity439 , with preoperative modeling of an optimal left ventricle volume. METHODS: From January 1998 to December 2000, 41 @entity1 underwent left ventricular (LV) @entity439 repair. There were 39 @entity1 and two @entity1 , with a mean age 45.6+/-6.2 years. With echocardiography study, an optimal end-diastolic volume of LV was modeled on the basis of the proper @entity64 index and the contractile ejection fraction (EF). A permissible area of @entity439 resection was calculated by using a difference between the initial and the projected surface area of LV. The patch position and sizes were measured preoperatively. Ventricular reconstruction was performed by using linear plasty in eight @entity1 , septal plasty of the Stoney et al. technique in 14 @entity1 , and endoventriculoplasty of the Dor et al. technique in 19 @entity1 . RESULTS: The mean NYHA functional class decreased from 2.9+/-0.6 to 1.6+/-0.7 postoperatively. The improvement of LV contracting function made itself evident in a decreased end-diastolic volume from 216+/-98 to 158+/-35 ml, and end-systolic volume from 133+/-85 to 80+/-34 ml postoperatively. The mean EF increased from 38+/-11 to 49+/-9% after operation. We noted that preoperative contractile EF corresponded with postoperative EF (49.8+/-11% and 49.3+/-9%, respectively). The projected optimal end-diastolic volume of LV estimated before operation agreed with postoperative data (152+/-33 ml and 158+/-35 ml, respectively). The hospital mortality rate was 7.3%. CONCLUSIONS: Preoperative modeling of an optimal LV volume allows for the estimation of a permissible area of @entity439 resection, the position and sizes of the patch, as well as for the prevention of an excessive reduction of the LV cavity after @entity439 repair.
