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Use of moldable titanium bars and rib clips for total sternal replacement: A new composite technique

2008; Elsevier BV; Volume: 138; Issue: 5 Linguagem: Inglês

10.1016/j.jtcvs.2008.09.034

1097-685X

Alessandro Gonfiotti, Paolo Santini, Domenico Andrea Campanacci, Marco Innocenti, Sante Ferrarello, A Jannî,

Pleural and Pulmonary Diseases

from the 67% preoperative value to 54%.Postoperative echocardiography revealed no paradoxical motion of the interventricular septum and a left ventricular ejection fraction of 47%.Cardiac magnetic resonance imaging revealed a left ventricular ejection fraction of 35.8% and left ventricular end-diastolic volume of 124.6 mL (Figure 2).There was no arrhythmia on 24-hour Holter monitor.Eight months after the operation, the patient was in New York Heart Association functional class I with digoxin and angiotensin-converting inhibitor medication.Measured values by echocardiography and cardiac magnetic resonance imaging are shown in Table 1. CONCLUSIONSIn this case, the right ventricular exclusion procedure not only normalized paradoxical interventricular septal motion but also increased effective volume loading of the left ventricle.The postoperative measured ratio (0.62 g/mL) of left ventricular mass to left ventricular end-diastolic volume, which was normalized by body surface area, increased more than the preoperative measured ratio (0.41 g/mL).As a result, left ventricular ejection fraction improved.The right ventricular exclusion procedure may be effective for repairing arrhythmia by resecting the arrhythmogenic dysplastic and dilated right ventricle.As in this case, the right ventricular exclusion procedure may be a good option for severe congestive right ventricular failure of Ebstein's anomaly.LVEF, Left ventricular ejection fraction; LVIDd, left ventricular internal diastolic diameter; LVEDV, left ventricular end-diastolic volume; CO, cardiac output; RVEDV, right ventricular end-diastolic volume; MRI, magnetic resonance imaging.