Quality of Life after 114 months of follow-up following geometric reconstruction of the left ventricle by endoventriculoplasty with septal exclusion

Abstract

Background: The purpose of this study was to present the surgical experience of the Institute of Cardiovascular Surgery of West of Paraná (ICCOP) with respect to the treatment of left ventricle aneurysms by endoventriculoplasty with septal exclusion (EVSE) and to evaluate the quality of life of these patients after a 114-month follow-up.

Methods: Between April 1999 and April 2006, 28 patients underwent EVSE. Preoperative, transoperative, and late postoperative clinical and echocardiographic variables were analyzed retrospectively. In addition, latepostoperative quality of life was evaluated with questionnaire SF-36 (Brazilian version). The mean age (+/-SD) of the group was 59.0 +/- 9.5 years, and 23 of the patients were male. Seventeen patients were in New York Heart Association functional class IV, and the mean preoperative EuroSCORE was 8.2 +/- 2.3. The mean preoperative values for the ejection fraction (EF) and the end-systolic and end-diastolic left ventricular volumes were 32.3% +/- 9.2%, 113.9 +/- 36.0 mL, and 179.2 +/- 48.4 mL, respectively.

Results: The in-hospital mortality rate was 14.3%, with the major causes of morbidity being low cardiac output syndrome and arrhythmias. The mean follow-up period was 5.9 +/- 3.4 years. The left ventricular EF and the aortic cross-clamping time were the significant factors for hospital and late mortality (P = .0222, and P = .0123, respectively). The actuarial survival curve showed survival rates of 82.1 +/- 7.2%, and 54.7 +/- 22.9%, before and after 107 months of follow-up. The overall score for the quality of life showed an improvement.

Conclusion: EVSE surgery is an effective option for treating this group of patients, with improvement noted in left ventricular function and in the patients' quality of life, despite the high in-hospital mortality.