F. Kim et Es. Yee, SURGICAL RECONSTRUCTION AND MUSCULAR AUGMENTATION OF VENTRICULAR REPAIRS - THEIR IMPACT ON COMPLIANCE AND STROKE VOLUME BY COMPUTER-SIMULATIONS, Vascular surgery, 27(8), 1993, pp. 597-602
Computer simulation techniques were used to explore direct versus patc
h reconstructive repairs on left ventricular dynamics after damages of
myocardial infarction, aneurysmal dilatation, and compensatory hypert
rophy. This ellipsoid geometric modeling allowed further assessment of
these three pathological stages on left ventricular compliance (dV/dP
) and stroke volume (SV). Primary surgical closure after any myocardiu
m resection created a smaller ventricular cavity and, thus, decreased
SV Similarly, dV/dP by direct closure is markedly in each of these thr
ee transitional stages. In comparison, for the patch repair techniques
, SV after augmentation by skeletal muscle ventriculoplasty offered th
e most immediate recovery after acute apical infarct with relatively l
ittle change in dV/dP Synthetic patch repair after aneurysmal and/or h
ypertrophy formation preserved the best SV despite negative shifts in
dV/dP Therefore, maintaining geometric shape and retaining functional
continuity are important operative considerations for optimizing SV an
d minimizing the negative impact in dV/dP Computer simulation models h
ave been extensively used to predict the impact of various operative r
epair on ventricular compliance and stroke volume. These techniques al
low detailed evaluation of newer or experimental reconstructive surgic
al procedures such as skeletal muscle ventriculoplasty.