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Excision of Akinetic Left Ventricular Wall for Intractable Heart Failure.

Herman L. Falsetti, M.D.; George M. Schimert, M.D.; Ivan L. Bunnell, M.D., F.A.C.P.; David C. Dean, M.D., F.A.C.P.; Andrew A. Gage, M.D.; Colin Grant, M.D.; and David G. Greene, M.D., F.A.C.P.
Ann Intern Med. 1968;68(5):1154. doi:10.7326/0003-4819-68-5-1154_2
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The advent of cineventriculography has made it clear that there is a spectrum of motion disturbances involving the left ventricular wall. Akinesis, or lack of wall motion, is one serious complication of myocardial infarction that may have a profound effect on cardiac hemodynamics. Cineangiograms of the left ventricle, performed in association with coronary arteriography, revealed large areas of akinesis in three patients with uncontrollable heart failure, associated with an elevated left ventricular end-diastolic pressure and an increased residual fraction (end-systolic volume divided by end-diastolic volume).

Areas of noncontractible left ventricular myocardium were excised, using cardiopulmonary bypass. Noncontractile areas can best


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