Comparative characteristics of preoperativeleft ventricle modeling based on echocardiography and magnetic-resonance tomography data
Background. Selection of an optimum surgical intervention for postinfarction heart aneurysm is based, at the stage of planning, on accurate evaluation of LV volumetric and functional parameters. Magnetic resonance tomography (MRT) allows detailed evaluation of LV contractility and overall myocardium viability, which is essential for selection of the LV plasty method. Aim. To evaluate the method of preo­perative LV cavity modeling in patients with postinfarction heart aneurysm based on MRT data. Materials and methods. Surgical reconstruction of LV cavity with myocardial revascularization was performed in 45 patients. Mean age of patients was 56.9±10. Mean number of MIs per patient was 1.5±0.9. Surgical interventions were performed under the conditions of extracorporeal circulation and normothermia for all patients. In-hospital mortality was absent. According to data of preoperative EchoCG, in 4-chamber view, the LV end-diastolic vo­lume (EDV) was 189.1±518 ml and LV EF was 38.2±6.0 %; in 2-chamber view, LV EDV was 204.5±54.6 ml and LV EF was 38.6±6.8 %. According to preoperative MRT, LV EDV was 252.2±60.5 ml and LV EF was 27.1±7.1 %. Results. In the modeling based on MRT, LV EDV should be 189.7±424 ml; LV EF - 33.9±7.6 %; and the resection area - 42.7±14.7 cm 2. According to data of the follow-up postoperative MRT, LV EDV was 197.5±42.0 ml (p=0.18) and LV EF was 30.9±8.5 % (p=0.001). Conclusion. In postinfarction heart aneurysm, the preoperative modeling of LV cavity based on MRT data is unbiased and allows clear outlining the required area of LV cavity resection to create necessary conditions for recovery of myocardial contractility. This method is safe and does not increase in-hospital mortality.