JTCS Medtronic Endurant
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Raja Joshi
Smartin Abraham
Arkalgud Sampath Kumar
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Joshi, R.
Right arrow Articles by Kumar, A. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Joshi, R.
Right arrow Articles by Kumar, A. S.
Related Collections
Right arrow Congestive Heart Failure

J Thorac Cardiovasc Surg 2003;125:40-42
© 2003 The American Association for Thoracic Surgery

Evolving Technology (ET)

New approach for complete endocardiectomy in left ventricular endomyocardial fibrosis

Raja Joshi, MCh, Smartin Abraham, MS, Arkalgud Sampath Kumar, MCh

From the Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.

Received for publication April 23, 2001. Revisions requested Jan 23, 2002; revisions received April 23, 2002. Accepted for publication May 1, 2002. Address for reprints: A. Sampath Kumar, MCh, Professor, Department of Cardiothoracic and Vascular Surgery, AIIMS, Ansari Nagar, New Delhi, 110029, India. (E-mail: asampath_kumar@hotmail.com).

The first 20% of the full text of this article appears below.


   Introduction
 


Figure Removed (Available Only in the Full Text)
View larger version (134K):
[in this window]
[in a new window]
  		Dr Kumar

 
Intracardiac exposure for excision of the endocardium during surgery for endomyocardial fibrosis has previously been achieved through the atrium, the ventricle, and the interatrial septum. Poor visualization of the apex and lateral wall of the left ventricle poses difficulties in complete resection of the thickened endocardium in these regions, leading to residual problems. We describe a transaortic-transatrial approach for excellent visualization and successful total endocardiectomy of left ventricular endomyocardial fibrosis. This approach is feasible, easy, and safe.

In this report we describe a new approach for the surgical treatment of endomyocardial fibrosis.


   Patient and method
 
Clinical summary
A 17-year-old girl from an area without endemic endomyocardial fibrosis had exertional dyspnea (New York Heart Association functional class III) and palpitations of 3 to 4 months in duration. No history suggestive of a rheumatic origin was forthcoming.

Clinical examination revealed cardiac enlargement, hyperdyanamic precordium and a harsh (grade 4/6) systolic murmur at the apex. Chest radiography showed cardiomegaly, biatrial enlargement, and pulmonary venous hypertension. Electrocardiography showed changes consistent with left ventricular hypertrophy.

Transthoracic echocardiography revealed prolapse of the anterior mitral leaflet with severe (4+) mitral regurgitation, enlarged left atrium (50 mm), and dilated left ventricle (46 mm at end-diastole and 26 mm at end-systole). The aortic anulus measured 23 mm (Figure 1, A and B). Left ventricular ejection fraction was 55% with diastolic dysfunction (E wave/A wave ratio of 1.2:0.2 and deceleration time of 130 . . . [Full Text of this Article]




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
K. R. Vaidyanathan, R. Venkatraman, M. N. Sankar, and K. M. Cherian
Endomyocardial Fibrosis in an Adult Mimicking Left Ventricular Mass
Ann. Thorac. Surg., September 1, 2008; 86(3): 1004 - 1006.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2003 by The American Association for Thoracic Surgery.