Left Ventricular Power Failure Research Articles

Management of papillary muscle dysfunction after acute myocardial infarction

A 52-year-old man developed left ventricular power failure after anterolateral myocardial infarction. Emergency cardiac catheterization revealed mitral regurgitation with normal right and left anterior descending coronary arteries. Significantly, the left circumflex coronary artery was diminutive in size, and no branches to the region of the anterolateral papillary muscle were demonstrated. Acute papillary muscle dysfunction was found at operation. Mitral valve replacement was successfully performed within 1 week of the myocardial infarction and development of papillary muscle dysfunction. The patient had returned to full activity 6 months after the operation.

Intra-aortic balloon counterpulsation and coronary revascularization for left ventricular power failure.

Combined use of intra-aortic balloon counterpulsation (IABCP) and coronary revascularization was utilized in 28 patients with acute and chronic left ventricular power failure (LVPF) and ischemic dysrh

Left ventricular gallop sound and acute myocardial infarction

A ventricular gallop sound, pulmonary râles, and cardiogenic shock have important prognostic implications in patients with acute myocardial infarction. The purpose of this study was to examine the relationship between VGS and death in myocardial infarction. A VGS was audible in 63 of 156 patients (40 per cent) with proved myocardial infarction admitted to a Myocardial Infarction Research Unit during a 24 month period. Fifty-three patients were studied hemodynamically, and 25 of 27 patients with an S 3 gallop demonstrated an abnormally elevated pulmonary artery enddiastolic pressure greater than 12 mm. Hg. Hospital deaths occurred in 40 per cent of patients with a VGS versus 15 per cent of those without this auscultatory finding. Seventy-five per cent of patients in cardiogenic shock died, but a VGS was not significantly associated with death in this group. Although in all patients a VGS was associated with increased mortality rate, deaths were not due to cardiogenic shock. This study confirms the need for hemodynamic monitoring in patients with acute myocardial infarction who exhibit a VGS as evidence of left ventricular power failure. Treatment should be based upon both clinical observations and continued evaluation of the hemodynamic alterations associated with left ventricular power failure.

A Simple Method to Facilitate Difficult Intraaortic Balloon Insertions

Intraaortic balloon pumping (IABP) is the supportive treatment of choice for the management of refractory left ventricular power failure. Concurrent arteriosclerotic disease, however, may make balloon insertion difficult. A new technique of insertion is described in which the proximal dual-chambered balloon is bent to facilitate the negotiation of tortuosities and arteriosclerotic junctures, thereby broadening the application of clinical IABP.