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Braz J Cardiovasc Surg. 2019 Mar-Apr;34(2):187-193. doi: 10.21470/1678-9741-2018-0366.

Left Ventricular Aneurysm Repair: Off-pump Linear Plication versus On-pump Patch Plasty.

Wei H1,2, Chai S3, Liu C1,2, Huang X1,2, Gu C1,2.

Author information

1
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
2
Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
3
Department of Cardiac Surgery, Liaocheng People's Hospital, Clinical School of Taishan Medical University, Shandong, China.

Abstract

OBJECTIVE:

The study aimed to compare the clinical outcomes of simplified linear plication and classic patch plasty in patients with left ventricular aneurysm (LVA).

METHODS:

We retrospectively reviewed 282 patients undergoing LVA repair between 2006 and 2016. After propensity score matching, 45 pairs of patients receiving LVA surgery were divided into either a patch group (on-pump endoventricular patch plasty) or a plication group (off-pump linear plication). Then, their early surgical outcomes and long-term survival were compared in two matched groups.

RESULTS:

The heart function improvement at discharge was similar in the two matched groups, while patients in the patch group more commonly suffered from low cardiac output syndrome (P=0.042) with higher proportion of intra-aortic balloon pumping assistance (P=0.034) than patients in the plication group. Compared with patients in the patch group, the patients in the plication group had shorter recovery times, regarding to mechanical ventilation, intensive care unit stay, and hospital stay (P<0.001, P<0.001, and P=0.001, respectively). No significant difference was found in the long-term survival (P=0.62).

CONCLUSIONS:

Off-pump linear plication presented acceptable results in terms of early outcomes and long-term survival. For high-risk patients, the simplified LVA repair technique may be an option.

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