Surgical repair of acquired XXXX . Determinants of early and late outcome.

@entity1 @entity1188 @entity1757
Between January 1970 and June 1985, 60 @entity1 underwent surgical repair of postinfarction @entity1757 . The preoperative cineangiograms of all @entity1 were reviewed to measure left ventricular ejection fraction and to quantitatively assess right ventricular function by measuring the percentage reduction in right ventricular midcavity diameter. There were 23 early deaths (within 30 days) and 14 late deaths occurring between 1 and 92 months after operation. Of the 23 long-term survivors, 87% are in New York Heart Association Class I or II. The early mortality was significantly higher for inferior @entity1188 (58%) than for anterior @entity1188 (25%). Early mortality was also influenced by the time interval between @entity1188 and operation (under 1 week 41%, over 4 weeks 22%). Early survival was favored by good preoperative right ventricular function; the percentage reduction in right ventricular midcavity diameter was 16.5% +/- 9.5% (mean +/- standard deviation) for the early death group and 26.7% +/- 10.6% for the early survival group. However, the early outcome was not influenced by left ventricular function before operation. Conversely, long-term survival was favored by preserved preoperative left ventricular function; left ventricular ejection fraction was 26.2% +/- 9.3% for the late death group and 35% +/- 8.5% for the late survival group. Long-term survival was not, however, affected by right ventricular function before operation. The results of surgical closure of postinfarction @entity1757 have improved between two successive time frames in this series, which is the largest to date.
