The IX t h Makassed Medical Congress - American University of Beirut
The IX t h Makassed Medical Congress - American University of Beirut
The IX t h Makassed Medical Congress - American University of Beirut
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ELECTOPHYSIOLOGY IN HEART FAILURE<br />
Oussama Musbah Wazni, MD<br />
As more patients with heart failure are being diagnosed and treated it is becoming more evident<br />
that these patients invariably need to be treated by electrophysiologists.<br />
In addition for the need <strong>of</strong> device therapy such as ICDs and CRTDs these patients frequently<br />
develop VT or recurrent ICD shocks. This is usually first treated with antiarrhythmics medications<br />
but also not infrequently these patients need EPS and ablation.<br />
Also patients with heart failure increasingly develop atrial fibrillation with worsening functional<br />
status and also worsening left ventricular function again in this group <strong>of</strong> patients AF ablation has<br />
been shown to be effective.<br />
In this session we will discuss in more depth the role <strong>of</strong> electrophysiological studies and ablative<br />
therapy in patients with heart failure.<br />
SURGICAL VENTRICULAR RESTORATION (SVR)<br />
THE EARLY EXPERIENCE IN SAUDI ARABIA<br />
Walid Abukhudair; E. Ahmed; A. Ajam; W. Ahmed;<br />
K. Shaibi; M. El-Hamami; A. Ashmeg<br />
Objectives: To evaluate our early experience with SVR as therapy for a subset <strong>of</strong> patients with<br />
ischemic cardiomyopathy.<br />
Background: Ischemic cardiomyopathy poses a challenging problem to the cardiologist and<br />
cardiac surgeons. Following myocardial infraction, 20% <strong>of</strong> patients develop ventricular dilation<br />
and congestive heart failure (CHF) even with early reperfusion therapy. This is due to “ventricular<br />
remodeling” process that results in the loss <strong>of</strong> the normal elliptical shape <strong>of</strong> the ventricle and CHF.<br />
Ventricular volume reduction, and shape restoration surgery has recently become an available<br />
option for this subset <strong>of</strong> patients. We prospectively examined the early outcome <strong>of</strong> SVR in our<br />
institution.<br />
Methods: Eight prospective post anterior myocardial infraction patients underwent SVR with<br />
concomitant CABG /or mitral valve repair are presented.<br />
We also reviewed the stich trial result in a critical EBM method.<br />
Results: 110 SVR patient were done between March 2006 to March 2010.<strong>The</strong> mean age was 50.6<br />
(+ 5.1) years. All patients were males. <strong>The</strong> mean left ventricular fraction was 20 % ± 3.16. One<br />
hundred patient had SVR with concomitant CABG. Thirty five patients had mitral valve repair as<br />
well. <strong>The</strong> average number <strong>of</strong> grafts was 2 + 0.63. <strong>The</strong> NYHA class has improved from 3.3 (+ 0.8) to<br />
1.8 + 0.4. <strong>The</strong> mean left ventricular ejection fraction improved from 20 + 3.16 to 30.8 + 5.8.<br />
<strong>The</strong> post-op ventilation period was 40 hours (+ 1.9) and the mean length <strong>of</strong> stay was 12.8 (+ 4.7)<br />
days. Intra aortic balloon pump (IABP) and Levosimendan were used in 40 patients. <strong>The</strong>re is one<br />
intra operative mortality and mortality rate was 5 %. STICH did not select same patient population<br />
and did not treat them the write way in terms <strong>of</strong> technique and LV reduction.<br />
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