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Surgical Ventricular Restoration: Left Ventricular Shape Influence on Cardiac Function, Clinical Status, and Survival  Marisa Di Donato, MD, Serenella.

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Presentation on theme: "Surgical Ventricular Restoration: Left Ventricular Shape Influence on Cardiac Function, Clinical Status, and Survival  Marisa Di Donato, MD, Serenella."— Presentation transcript:

1 Surgical Ventricular Restoration: Left Ventricular Shape Influence on Cardiac Function, Clinical Status, and Survival  Marisa Di Donato, MD, Serenella Castelvecchio, MD, Tomasz Kukulski, MD, Claudio Bussadori, MD, Francesca Giacomazzi, MD, Alessandro Frigiola, MD, Lorenzo Menicanti, MD  The Annals of Thoracic Surgery  Volume 87, Issue 2, Pages (February 2009) DOI: /j.athoracsur Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Left ventricular (LV) shape abnormalities after myocardial infarction, as evaluated in right anterior oblique (RAO) 30° LV angiography are shown. Type 1 (true aneurysm) is geometrically delimited by two systolic “borders” between thickening and nonthickening myocardium; the classic neck of the true aneurysm is evident. In type 2 (intermediate), the shape is characterized by only one border between thickening and nonthickening myocardium, instead of two borders as in type 1, and the term “intermediate” is used because type 2 is between type 1 (two borders) and type 3 (no borders). In type 3 (ischemic dilated cardiomyopathy), the LV systolic shape is without borders (ie the curvature is flattened along the overall perimeter of the LV). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 In the Mancini curvature analysis, the curvature values are on the ordinate (1/r) and ventricular regions are on the abscissa. AB = anterobasal; AL= anterolateral; AP = apical; DI = diaphragmatic; PB = posterobasal. The shadow area represents curvature values in healthy subjects and the black line represents 1 patient with type 1 aneurysm. Note the greatest value of wall curvature at apical level in healthy subjects and the flattening of the apical curvature in the patient. Note the abrupt variation of curvature in the patient (from negative to positive and positive to negative at the anterobasal and posterobasal regions, respectively). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (Left) Echo 2-chamber view and (Right) right anterior oblique (RAO) 30° angiographic view. Imaging plane discrepancies and similarities are shown. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Images from three patients with type 1, 2, and 3 left ventricular shape abnormalities show that all three types have chamber dilatation and a markedly reduced ejection fraction, but the shape is definitely different. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Kaplan-Mayer survival curve in type 1 (black squares), 2 (white squares), and 3 (white circles) are reported. All-cause mortality is reported, and operative mortality is included. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

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