medigraphic.com
ISSN 1561-2937 (Impreso)

2017, Número 1

<< Anterior Siguiente >>

Rev Cubana Cardiol Cir Cardiovasc 2017; 23 (1)


Cirugía de revascularización miocárdica en la disfunción sistólica ventricular izquierda, una opción viable para nuestros pacientes

Rodríguez RV

Idioma: Español
Referencias bibliográficas: 26
Paginas:
Archivo PDF: 201.00 Kb.


FRAGMENTO

La disfunción ventricular izquierda es un determinante fundamental de la evolución clínica en la cardiopatía isquémica (CI). La disfunción ventricular crónica, difusa y severa es un reconocido factor de mal pronóstico en la evolución natural de la enfermedad. La cirugía de revascularización miocárdica (CRM) se ha convertido en el tratamiento de elección de los pacientes con CI extensa y función ventricular deprimida. En este contexto, los procedimientos de revascularización miocárdica ofrecen una doble expectativa: por un lado son capaces de preservar el miocardio funcional, y por otro permiten la recuperación total o parcial del músculo cardíaco viable. En estudios prospectivos y aleatorizados publicados en los años ochenta quedó demostrado que los pacientes con disfunción ventricular izquierda sometidos a CRM tienen mayor supervivencia y mejoría funcional que los que son tratados de manera conservadora y, además, que el beneficio de la CRM es tanto mayor cuanto peor es la función ventricular.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Louie HW, Laks H, Milgater E, Drinkwater DC Jr, Hamilton MD, Brunken RC et al. Ischemic cardiomyopathy. Criteria for coronary revascularization and heart transplantation. Circula-tion 1991; 84 (Supl 3): 290-95.

  2. Milano CA, White WD, Smith LR, Jones RH, Lowe JE, SmithPK et al. Coronary artery bypass in patients with severe-ly depressed ventricular function. Ann ThoracSurg 1993; 53: 487-93.

  3. Luciani GB, Faggian G, Razzolini R, Livi U, Bortolotti U, Mazzucco A. Severe ischemic left ventricular failure: coro-nary opera- tion or heart transplantation? Ann ThoracSurg 1993; 55: 719-23.

  4. The Veterans Administration Coronary Artery Bypass Sur-gery Cooperative Study Group. Eleven-year survival in the Veterans Administration randomized trial of coronary bypass surgery for stable angina. N Engl J Med 1984; 311: 1333-339.

  5. Ong AT, Serruys PW, Mohr FW, Morice MC, Kappetein AP, Holmes DRJr, et al. The SYNergy between percutaneous co-ronary interventionwith TAXus and cardiac surgery (SYN-TAX) study: design, rationale, andrun-in phase. Am Heart J. 2006; 151:1194-204.

  6. Farkouh ME, Dangas G, Leon MB, Smith C, Nesto R, Buse JB, et al. Design of the Future REvascularization Evaluation in patients with Diabetes mellitus: Optimal management of Mul-tivessel disease (FREEDOM) Trial. Am Heart J. 2008;155(2):215-23.

  7. Passamani E, Davis KB, Gillespie MJ, Killip T. CASS prin-cipal investigators and associates. A randomized trial of coro-nary artery surgery bypass: survival of patients with a low ejection fraction. N Engl J Med 1985; 312: 1665-671.

  8. Wijns W, Kolh P, Danchin N, Di Mario C, Falk V, Folliguet T, et al. Guía de práctica clínica sobre revascularización miocárdica. RevEspCardiol. 2010; 63(12): 1485-561.

  9. Parsonnet V, Dean D, Bernstein AD. A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease. Circulation. 1989; 79(Supp 6): I3-I12.

  10. Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999; 16(1): 9-13.

  11. Singh M, Rihal CS, Lennon RJ, Spertus J, Rumsfeld JS, Holmes DR Jr. Bedside estimation of risk from percutaneous coronary intervention: the new Mayo Clinic risk scores. Mayo Clin Proc. 2007; 82: 701-8.

  12. Ranucci M, Castelvecchio S, Menicanti L, Frigiola A, Pelis-sero G. Risk of assessing mortality risk in elective cardiac op-erations: age, creatinine, ejection fraction, and the law of par-simony. Circulation. 2009; 119(24): 3053-61.

  13. Velazquez EJ, Lee KL, O'Connor CM, Oh JK, Bonow RO, Pohost GM, et al. The rationale and design of the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. J Thorac Cardiovasc Surg. 2007; 134:1540–7.

  14. Vom Dahl J, Eitzman DT, AL-Aouar ZR, Kanter HL, Hicks RJ, Deeb GM, et al. relation of regional function, perfusion, and me- tabolism in patients with advanced coronary artery disease under- going surgical revascularization. Circulation. 1994; 90:2356-366.

  15. Di Carli MF. Predicting improved function after myocardial re- vascularization. CurrOpinCradiol. 1988; 13:415-24.

  16. Di Carli MF, Maddahi J, Rokhsar S, Schelbert HR, Bianco-Bat- lles D, Brunken RC, et al. Long-term survival of patients with co- ronary artery disease and left ventricular dysfunction: implica- tions for the role of myocardial viability assessment in management decisions. J ThoracCardiovasc Surg. 1998; 116:997- 1004.

  17. Doenst T, Cleland JGF, Rouleau JL, et al. Influenceof cros-sover on mortality in a randomizedstudy of revascularization in patients with systolicheart failure and coronary artery dis-ease. CircHeart Fail 2013; 6:443–50.

  18. Mancini GBJ, Hartigan PM, Shaw LJ. Predicting outcome in the COURAGE trial.Coronaryanatomy versus ischemia. J Am CollCardiolIntv 2014; 7:195–201

  19. Yamaguchi A, Ino T, Adachi H, Murata S, Kamio H, Okada M, et al. Left ventricular volume predicts postoperative course in patients with ischemic cardiomyopathy. Ann Thorac Surg 1998; 65:434-8.

  20. Vanoverschelde JL, Depre C, Gerber BL, Borges M, Wijns W, Robert A, et al. Time course of functional recovery after coronary artery bypass graft surgery in patients with chronic left ventricular ischemic dysfunction. Am J Cardiol 2000; 85:1432-9.

  21. Romero FG, Candell RJ, Aguadé BS, Castell CJ, Leóna G. Igual A. Variables predictoras de mejoría de la función sistóli-ca ventricular izquierda después de la cirugía de revasculari-zación coronaria en pacientes con miocardiopatía isquémica. Rev Esp Cardiol. 2007; 60(9):943-51.

  22. Passamani E, Davis KB, Gillespie MJ, Killip T. A randomi-zed trial of coronary artery bypass surgery: survival of patients with a low ejection fraction. N Engl J Med 1985; 312:1665-71.

  23. Yusuf S, Zucker D, Peduzzi P, Fisher LD, Takaro T, Kenne-dy JW, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Colla-boration. Lancet 1994; 344:563-70.

  24. Bell MR, Gersch BJ, Schaff HV, Holmes DR Jr, Fisher LD, Alderman EL, et al. Effect of completeness of revasculariza-tion on long-term outcome of patients with three vessel disea-se undergoing coronary artery bypass surgery: a report from the Coronary Artery Surgery Study (CASS) Registry. Circula-tion 1992; 86;2:446-57.

  25. Allman KC, Slaw LJ, Hachamoviteh R, Udelson JE. Myo-cardial viability testing an impact of revascularization on prognosis in patients with coronary artery disease and left ven-tricular dysfunction: a metaanalysis. J Am Coll Cardiol 2002; 39:1151-8.

  26. Luciani GB, Montalbano G, Casali G, Mazzucco A. Predic-ting longterm functional results after myocardial revasculari-zation in ischemic cardiomyopathy. J Thorac Cardiovasc Surg 2000; 120:478-89.




2020     |     www.medigraphic.com