Resonancia magnética cardíaca prequirúrgica y de seguimiento en pacientes candidatos a endoventriculoplastia

Abstract

PurposeTo assess pre and post-operative cardiac MRI (CMR) findings in patients with left endoventriculoplasty repair for ventricular aneurysm due to ischemic heart disease. Material and methodsData were retrospectively gathered on 21 patients with diagnosis of ventricular aneurysm secondary to ischemic heart disease undergoing left endoventriculoplasty repair between January 2007 and March 2013. Pre and post-operative CMR was performed in 12 patients. The following data were evaluated in pre-operative and post-operative CMR studies: quantitative analysis of left ventricular ejection fraction (LVEF), left ventricular end-diastolic (LVEDV) and end-systolic (LVESV) volume index, presence of valvular disease and intracardiac thrombi. The time between surgery and post-operative CRM studies was 3–24 months. ResultsSignificant differences were found in the pre and post-operative LVEF, LVEDV and LVESV data. EF showed a median increase of 10% (IQR 2-15) (p=0.003). The LVEDV showed a median decrease of 38ml/m2 (IQR 18-52) (p=0.006) and the LVESV showed a median decrease of 45ml/m2 (IQR:12-60) (p=0.008). Post-operative ventricular volume reduction was significantly higher in those patients with preoperative LVESV >110ml/m2 (59ml/m2 and 12ml/m2, p=0.006). ConclusionIn patients with ischemic heart disease that are candidates for left endoventriculoplasty, CMR is a reliable non-invasive and reproducible technique for the evaluation of the scar before the surgery and the ventricular volumes and its evolution after endoventricular surgical repair.