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Objectives The authors investigated the impact of coronary artery bypass grafting (CABG) on first and recurrent hospitalization in this population. Background In the STICH (Surgical Treatment for Ischemic Heart Failure) trial, CABG reduced all-cause death and hospitalization in patients with and ischemic cardiomyopathy and left ventricular ejection fraction Methods A total of 1,212 patients were randomized (610 to CABG + optimal medical therapy [CABG] and 602 to optimal medical therapy alone [MED] alone) and followed for a median of 9.8 years. All-cause and cause-specific hospitalizations were analyzed as time-to-first-event and as recurrent event analysis. Results Of the 1,212 patients, 757 died (62.4%) and 732 (60.4%) were hospitalized at least once, for a total of 2,549 total all-cause hospitalizations. Most hospitalizations (66.2%) were for cardiovascular causes, of which approximately one-half (907 or 52.9%) were for heart failure. More than 70% of all hospitalizations (1,817 or 71.3%) were recurrent events. The CABG group experienced fewer all-cause hospitalizations in the time-to-first-event (349 CABG vs. 383 MED, adjusted hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.74 to 0.98; p = 0.03) and in recurrent event analyses (1,199 CABG vs. 1,350 MED, HR: 0.78, 95% CI: 0.65 to 0.94; p Conclusions CABG reduces all-cause, CV, and HF hospitalizations in time-to-first-event and recurrent event analyses. (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease [STICH]; NCT00023595)

Flotation of buried pipelines at cyclic freezing and thawing of the surrounding soil prevents normal operation of pipelines and may lead to their fracture. This problem is especially relevant for buried pipelines in freezing soils with high water content. The traditional explanation for this emergence of the phenomenon is the Archimedean force (even the term “flotation” indicates this). At the same time, a similar phenomenon known as “strain accumulation” or “ratcheting” is well known in high-temperature engineering. This phenomenon consists in the increase of a structure displacements with the number of loading cycles. Under certain conditions, such accumulation can become stable (the same in successive cycles) and lead to large accumulated displacements after a corresponding number of cycles. The study considers an attempt of applying the methods developed for analyzing displacement accumulation in high-temperature structures of power engineering industry, to the problem of pipeline flotation. It shows that such a mechanism (ratcheting) can play an important role in this task, and the choice of ways to counteract the flotation essentially depends on the process mechanism.

The work is devoted to the experimental study of steels and alloys deformation properties with account to the mutual influence of the cyclic and static deformation components. Carbon steel and three different chrome-nickel austenitic steels were tested at different temperatures and durations. At strain-controlled cyclic loading these steels demonstrate cyclic hardening (or softening – depending on the previous history) at the running-in stage, then stabilization and subsequent softening at the pre-fracture stage. Experiments show that in case of comparable cyclic and static damage the mutual influence of the cyclic and static material hardening (softening) strongly affects the stress-strain diagrams; this effect should be taken into account in structural analysis. Models that use only the information about static or strain-controlled cyclic loading are incapable to describe this effect.

The authors investigated the impact of coronary artery bypass grafting (CABG) on first and recurrent hospitalization in this population.In the STICH (Surgical Treatment for Ischemic Heart Failure) trial, CABG reduced all-cause death and hospitalization in patients with and ischemic cardiomyopathy and left ventricular ejection fraction 35%.A total of 1,212 patients were randomized (610 to CABG + optimal medical therapy [CABG] and 602 to optimal medical therapy alone [MED] alone) and followed for a median of 9.8 years. All-cause and cause-specific hospitalizations were analyzed as time-to-first-event and as recurrent event analysis.Of the 1,212 patients, 757 died (62.4%) and 732 (60.4%) were hospitalized at least once, for a total of 2,549 total all-cause hospitalizations. Most hospitalizations (66.2%) were for cardiovascular causes, of which approximately one-half (907 or 52.9%) were for heart failure. More than 70% of all hospitalizations (1,817 or 71.3%) were recurrent events. The CABG group experienced fewer all-cause hospitalizations in the time-to-first-event (349 CABG vs. 383 MED, adjusted hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.74 to 0.98; p = 0.03) and in recurrent event analyses (1,199 CABG vs. 1,350 MED, HR: 0.78, 95% CI: 0.65 to 0.94; p 0.001). This was driven by fewer total cardiovascular (CV) hospitalizations (744 vs. 968; p 0.001, adjusted HR: 0.66, 95% CI: 0.55 to 0.81; p = 0.001), the majority of which were due to HF (395 vs. 512; p 0.001, adjusted HR: 0.68, 95% CI: 0.52-0.89; p = 0.005). We did not observe a difference in non-CV events.CABG reduces all-cause, CV, and HF hospitalizations in time-to-first-event and recurrent event analyses. (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease [STICH]; NCT00023595).

Formulation and solution of a task for the composite engineering-geological interaction of a pipeline and a soil are considered. Finite element method is used for numerical analysis of the task, accounting for large displacements and corresponding strains under changing boundary conditions. The capability of the limit state reaching in the pipeline with loss of form stability is shown depending on pad layer and the pipe properties. It is demonstrated also that safety maintenance could be provided by usage of ribs, formed on a pipe by a cyclic thermomechanical actions.

Background: The STICH trial (Surgical Treatment for Ischemic Heart Failure) demonstrated a survival benefit of coronary artery bypass grafting in patients with ischemic cardiomyopathy and left ventricular dysfunction. The Society of Thoracic Surgeons (STS) risk score and the EuroSCORE-2 (ES2) are used for risk assessment in cardiac surgery, with little information available about their accuracy in patients with left ventricular dysfunction. We assessed the ability of the STS score and ES2 to evaluate 30-day postoperative mortality risk in STICH and a contemporary cohort (CC) of patients with a left ventricle ejection fraction ≤35% undergoing coronary artery bypass grafting outside of a trial setting. Methods and Results: The STS and ES2 scores were calculated for 814 STICH patients and 1246 consecutive patients in a CC. There were marked variations in 30-day postoperative mortality risk from 1 patient to another. The STS scores consistently calculated lower risk scores than ES2 (1.5 versus 2.9 for the CC and 0.9 versus 2.4 for the STICH cohort), and underestimated postoperative mortality risk. The STS and ES2 scores had moderately good C statistics: CC (0.727, 95% CI: 0.650–0.803 for STS, and 0.707, 95% CI: 0.620–0.795 for ES2); STICH (0.744, 95% CI: 0.677–0.812, for STS and 0.736, 95% CI: 0.665–0.808 for ES2). Despite the CC patients having higher STS and ES2 scores than STICH patients, mortality (3.5%) was lower than that of STICH (4.8%), suggesting a possible decrease in postoperative mortality over the past decade. Conclusions: The 30-day postoperative mortality risk of coronary artery bypass grafting in patients with left ventricular dysfunction varies markedly. Both the STS and ES2 score are effective in evaluating risk, although the STS score tend to underestimate risk. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT00023595.

Aim ― To reveal the results of the condition of the bone marrow mononuclear cells (BM-MNCs) with erythropoietin (Epo). Material and Methods ― There were 30-ty patients with coronary artery disease (CAD) enrolled in this study during 2016-2017 years. 95% were men. All were in angina NYHA class II-III. Hypertension presented in 90%, peripheral atherosclerosis in 60%. BM-MNCs were obtained by centrifugation of bone marrow aspirate on Ficoll-Paque, washed, and then preconditioned with Epo. Phenotype, cell cycle, cell death, proliferation, migration, and tube formation before, and after precondition BM-MNCs with Epo were done. Results ― In this study, we observed the presence in cellular graft of the hematopoietic stem cells (HSCs), and endothelial progenitor cells (EPCs) at the different stage of maturation/differentiation, and mesenchymal stem cells (MSCs). Precondition BM-MNCs with Epo increased number of HSCs carrying erythropoietin receptor (EpoR), and EPCs carrying CD184. Also, Epo detained СВ34+ cells in a rest phase of cell cycle (G0G1). Condition media from BM-MNCs treated with Epo augment tube formation and wound healing by EA.hy 929. Conclusion ― Epo in vitro increased number of the stem cells carrying EpoR and CD184, and increased accumulation of CD34+ cell in G0G1 phase of cell cycle, and induced production of proangiogenic factor by BM-MNCs. Further investigation is needed to assess the type of cytokines produced by BM-MNCs after condition with Epo.

Mitral regurgitation (MR) is common in ischemic heart disease and contributes to symptoms and mortality. This report compares the results of baseline transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) imaging of the mechanism and severity of functional MR in patients with ischemic cardiomyopathy in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Independent core laboratories measured both TTE and TEE images on 196 STICH participants. Common measurements to both models included MR grade, mitral valve tenting height and tenting area, and mitral annular diameter. For each parameter, correlations were assessed using Spearman rank correlation coefficients. A modest correlation was present between TEE and TTE for overall MR grade (n = 176, r = 0.52). For mechanism of MR, modest correlations were present for long-axis tenting height (n = 152, r = 0.35), tenting area (n = 128, r = 0.27), and long-axis mitral annulus diameter (n = 123, r = 0.41). For each measurement, there was significant scatter. Potential explanations for the scatter include different orientation of the imaging planes between TEE and TTE, a mean temporal delay of 6 days between TEE and TTE, and statistically significant differences in heart rate and blood pressure and weight between studies. In conclusion, TEE and TTE measurements of MR mechanism and severity correlate only modestly with enough scatter in the data that they are not interchangeable.

Objective To test the hypothesis that perioperative OMEGA-3 polyunsaturated fatty acid infusion would reduce the incidence of postoperative atrial fibrillation in patients after coronary artery bypass grafting as assessed by an implantable continuous cardiac monitor. Design Prospective, randomized, double-blind, placebo-controlled study. Setting Tertiary cardiothoracic referral center. Participants Thirty-nine patients with coronary artery disease who underwent surgery with cardiopulmonary bypass. Interventions Patients were assigned randomly to receive either OMEGA-3 polyunsaturated fatty acids (200 mg/kg/day starting before anesthesia induction for 24 hours followed by 100 mg/kg/day for 7 days) or placebo. The primary outcome was freedom from atrial fibrillation at 2-year follow-up. Reveal ® cardiac monitor was implanted subcutaneously in all patients. Data from the cardiac monitor were collected on the 10th day and 3, 6, 12, and 24 months postoperatively. Measurement and Main Results Postoperative atrial fibrillation developed in 4 (19%) patients in the control group and in 5 (27.8%) patients in the study group at 10-day follow-up (p = 0.88). At 2-year follow-up, 5 (27.8%) patients in the control group and 6 (35.3%) patients in the study group had atrial fibrillation (p = 0.9). Atrial fibrillation duration predicted risk of cardiovascular hospitalization at the 2-year follow-up (regression coefficient estimate = 0.24, standard error 0.02, p 2 = 0.74). Conclusions Infusion of OMEGA-3 polyunsaturated fatty acids failed to prevent the occurrence of atrial fibrillation in 2 years after coronary artery bypass grafting surgery. The cumulative atrial fibrillation duration registered by the continuous cardiac monitor at the 2-year follow-up was a significant predictor of an adverse outcome.

The mechanisms underlying functional mitral regurgitation (MR) and the relation between mechanism and severity of MR have not been evaluated in a large, multicenter, randomized controlled trial. Transesophageal echocardiography (TEE) was performed in 215 patients at 17 centers in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Both 2-dimensional (n = 215) and 3-dimensional (n = 81) TEEs were used to assess multiple quantitative measurements of the mechanism and severity of MR. By 2-dimensional TEE, leaflet tenting area, anterior and posterior leaflet angles, mitral annulus diameter, left ventricular (LV) end-systolic volume index, LV ejection fraction (LVEF), and sphericity index (p0.05 for all) were significantly different across MR grades. By 3-dimensional TEE, mitral annulus area, leaflet tenting area, LV end-systolic volume index, LVEF, and sphericity index (p0.05 for all) were significantly different across MR grades. A multivariate analysis showed a trend for annulus area (p = 0.069) and LV end-systolic volume index (p = 0.071) to predict effective regurgitant orifice area and for annulus area (p = 0.018) and LV end-systolic volume index (p = 0.073) to predict vena contracta area. In the STICH trial, multiple quantitative parameters of the mechanism of functional MR are related to MR severity. The mechanism of functional MR in ischemic cardiomyopathy is heterogeneous, but no single variable stands out as a strong predictor of quantitative severity of MR.

The paper presents research data demonstrating the effect of warm caliber rolling on the martensite transformation temperatures, shape memory effect, and superelasticity in Ti49.2Ni50.8 (at %). The experimental values of inelastic strain in coarse-grained and microcrystalline Ti49.2Ni50.8 (at %) specimens exceed the theoretical limit of recoverable strain or maximum lattice strain for TiNi-based alloys.

Aims The Surgical Treatment for Ischemic Heart Failure (STICH) trial demonstrated no overall benefit when surgical ventricular reconstruction (SVR) was added to coronary artery bypass grafting (CABG) in patients with ischaemic cardiomyopathy. The present analysis was to determine whether, based on baseline left ventricular (LV) function parameters, any subgroups could be identified that benefited from SVR. Methods and results Among the 1000 patients enrolled, Core Lab measures of baseline LV function with adequate quality were obtained in 710 patients using echocardiography, in 352 using cardiovascular magnetic resonance, and in 344 using radionuclide imaging. The relationship between LV end-systolic volume index (ESVI), end-diastolic volume index, ejection fraction (EF), regional wall motion abnormalities, and outcome were first assessed only by echocardiographic measures, and then by 13 algorithms using a different hierarchy of imaging modalities and their quality. The median ESVI and EF were 78.0 (range: 22.8–283.8) mL/m2 and 28.0%, respectively. Hazard ratios comparing the randomized arms by subgroups of LVESVI and LVEF measured by echocardiography found that patients with smaller ventricles (LVESVI 90 mL/m2) and lower LVEF (≤25%) did worse with SVR. Algorithms using all three imaging modalities found a weaker relationship between LV global function and the effects of SVR. The extent of regional wall motion abnormality did not influence the effects of SVR. Conclusions Subgroup analyses of the STICH trial suggest that patients with less dilated LV and better LVEF may benefit from SVR, while those with larger LV and poorer LVEF may do worse. Clinical Trial Registration #: [NCT00023595][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00023595&atom=%2Fehj%2F34%2F1%2F39.atom

Background: Epicardial implantation of a cardiac resynchronization therapy (CRT) system during coronary artery bypass grafting (CABG) may be an additional treatment method for improving left ventricle (LV) systolic function and dyssynchrony in patients with ischemic heart failure. Objective: The objective was to compare the long-term results in patients with severe ischemic heart failure who underwent CABG alone or CABG combined with concomitant epicardial implantation of a CRT system. Methods: One hundred sixty-four consecutive patients with severe ischemic heart failure and LV dyssynchrony were enrolled into 2 groups: CABG alone (n = 80) and epicardial CRT implantation during CABG (CABG + CRT) (n = 84). This prospective, randomized, and single-blind study was designed to compare clinical and echocardiography data after 6, 12, and 18 months of follow-up. Results: In the CABG group, LV systolic function, dyssynchrony signs, and quality of life did not change postoperatively, compared with preoperative data. In contrast, these parameters significantly improved in the CABG + CRT group. The 2 treatment groups did not differ with respect to postoperative improvement in Canadian Cardiovascular Society class ( P = .68). The improvement in the New York Heart Association functional class was much more pronounced in the CABG + CRT group than in the CABG group ( P = .029). In the CABG group, 21 patients (26.2%) had died by the 18-month follow-up, compared with 9 patients (10.7%) in the CABG + CRT group (P = .012, log-rank test). Conclusion: Epicardial implantation of a CRT system concomitantly with CABG facilitates the early postoperative period, improves LV systolic function, improves the quality of life, and decreases LV dyssynchrony. Moreover, mortality in the CABG + CRT group was significantly lower than in the CABG group.

TiNi shape memory alloys are nowadays widely used in engineering and medicine. The unique capabilities of this material are particularly apparent in applications for space technology. One of the actual present problems is the design of thermosensitive devices for space applications. In this work, we investigated a TiNi alloy as a working element material for the thermosensitive wire drive as an actuator. An optimum thermomechanical treatment of NiTi alloys was selected based on the analysis of functional and mechanical properties. It consists of a multi-cycle implementation of transformation plasticity under 220 MPa constant stress and a shape memory effect in the free state.

OBJECTIVES: We report our experience with a modified mini-maze procedure and pulmonary vein isolation using radiofrequency energy for treating persistent atrial fibrillation during coronary artery bypass grafting (CABG). METHODS: Ninety-five patients with persistent atrial fibrillation and coronary heart disease underwent open heart surgery combined with intraoperative irrigated radiofrequency ablation. Patients were randomized into the following three groups: CABG and irrigated radiofrequency pulmonary vein isolation (CABG+PVI, n= 31); CABG and an irrigated radiofrequency modified mini-maze procedure (CABG +MM, n= 30); and isolated CABG (CABG alone, n= 34). All patients received implantable loop recorders. RESULTS: No reoperation and no hospital mortality were recorded. Mean follow-up was 14.4 ± 9.7 months. The implantable loop recorder-determined freedom from atrial fibrillation was 80% in the CABG+PVI group, 86.2% in the CABG+MM group and 44.1% in the CABG alone group. CONCLUSIONS: Patients with concomitant atrial fibrillation and coronary heart disease may benefit from intraoperative ablation to prevent relapse of arrhythmia.

OBJECTIVES: Whether patients with recent onset of paroxysmal atrial fibrillation (PAF) might benefit of epicardial atrial fibrillation (AF) ablation concomitant to coronary artery bypass graft (CABG) is not known. The aim of this prospective, randomized, single-centre pilot study is the comparison of patients with first diagnosed AF submitted to CABG and treated with and without epicardial pulmonary vein isolation (PVI). METHODS: Patients with first diagnosed PAF and indication for CABG were enrolled in this prospective randomized pilot study. The primary endpoint was AF-free survival (AF burden

The study aimed to identify responders to atrial fibrillation (AF) ablation, through continuous subcutaneous monitoring in patients with paroxysmal atrial fibrillation (PAF), who underwent epicardial pulmonary vein isolation (PVI) concomitantly with coronary artery bypass grafting (CABG).Seventy-two patients aged 61.6±4.7 years with PAF underwent epicardial PVI with bipolar radiofrequency during CABG. Conduction block was confirmed by pacing. At the end of the procedure, the implantable loop recorder (ILR) for continuous monitoring was implanted in all patients. Follow-up data were collected through the ILR telemetry. Patients with an AF burden (AF%)0.5% were considered AF free (responders). Patients with AF%0.5% were classified as non-responders. The AF episodes stored by the implanted device were visually inspected by the investigators to confirm the arrhythmia. The data were collected each month during 1-year follow-up.No procedure-related complications occurred either for ablation or for the monitoring device. At the first post-ablation follow-up (1 month) during the blanking period, 37 patients (51%) were AF free, that is, with AF%0.5%. At the end of the blanking period (3rd follow-up), 44 (61%) patients were AF free. At 12 months' follow-up, 52 (72%) patients were AF free. Among 20 (28%) patients with AF recurrence, six (30%) patients were completely asymptomatic. There were no ischaemic strokes during the 1-year follow-up.Concomitant AF ablation during CABG is effective in the treatment of AF, as assessed through 1 year of continuous monitoring. Use of subcutaneous monitors is safe and accurate for AF detection, clinically relevant in identifying responders and non-responders and managing the medical therapies accordingly.

Objective: We have tested the hypothesis that epicardial implantation of cardiac resynchronisation therapy (CRT) system during coronary artery bypass grafting (CABG) may be an additional treatment method, which can decrease the mortality and improve left ventricle (LV) systolic function in patients with ischaemic heart failure (HF) and LV dyssynchrony. Methods: One hundred and seventy-eight consecutive patients with severe ischaemic HF and LV dyssynchrony were enrolled in two groups: CABG alone (n = 87) and epicardial CRTimplantation during CABG (n = 91). The primary end point of the study was the comparison of mortality between two groups at 18 months of follow-up. Results: Twenty-three patients (26.1%) in the CABG group died at 18 months of follow-up compared with nine (10%) in CABG + CRT group (log-rank test, p = 0.006). The Cox regression analysis revealed that LV dyssynchrony (hazard ratio (HR) 2.634 (1.206—5.751), p = 0.015) was the independent predictor of allcause death and HF hospitalisation. LV systolic function, dyssynchrony signs and qualityof life did not changesignificantly post-CABG comparedto pre-CABG data in CABG group patients. On the contrary, echocardiography revealed an improved LV ejection fraction (42 � 1.9 vs 28 � 2.7; p < 0.001), smaller LV end-systolic volume (120 � 57.5 vs 164 � 61.4; p = 0.04) and improved LV synchrony in the CABG + CRT group compared with the CABG group. In the CABG + CRT group, more patients improved by two NYHA classes (NYHA, New York Heart Association; 49 vs 0; p = 0.028), had a longer 6-min-walk test distance (452 � 65 vs 289 � 72; p < 0.001) and a better quality of life (22.9 � 5 vs 46.4 � 11; p < 0.001) compared with the CABG group. Conclusion: For majority of the patients with ischaemic HF and evidence of LV dyssynchrony, CABG neither eliminates dyssynchrony nor improves systolic function. Epicardial implantation of a CRT system concomitant with CABG facilitates patient management in the early postoperative period, improves LV systolic function and quality of life and is associated with low mortality at 18 months of follow-up.

Objective: We evaluated left ventricular dimensions and shape in the patients with postinfarction LV aneurysm before and after different techniques of ventricular reconstruction. Methods: From January 1997 to December 2003, 158 patients underwent LV aneurysm repair. There were 152 men and 6 women, with a mean age 50G8.4 years. Ventricular reconstruction was performed by using linear plasty of the Cooley technique in 35 patients, septal plasty of the Stoney technique—in 57 patients, and endoventriculoplasty of the Dor technique—in 66 patients. Left ventricular volumes and dimensions, global and contractile left ventricular function, diastolic sphericity were analyzed before and after operation over a period of 10 days to 5 years. Results: The EchoCG studies showed a significant postoperative improvement of the LV contracting function regardless of LV plasty technique used. The index of sphericity changed from 0.71G0.08 to 0.72G0.06 after linear plasty, from 0.71G 0.05 to 0.73G0.07 after septal plasty, from 0.74G0.06 to 0.56G0.05 after endoventriculoplasty. The hospital mortality rate was 6.3%. There is no significant difference in hospital mortality rates between the different techniques of LV aneurysm repair. Conclusions: Our results show the effectiveness of different techniques of LV aneurysm repair, when the differentional approach to choice an adequate method of ventricular reconstruction was applied. q 2005 Elsevier B.V. All rights reserved.

Objective: We evaluated the results of surgical treatment postinfarction ventricular aneurysms, with preoperative modeling of an optimal left ventricle volume. Methods: From January 1998 to December 2000, 41 patients underwent left ventricular (LV) aneurysm repair. There were 39 men and two women, with a mean age 45.6 ^ 6.2 years. With echocardiography study, an optimal end-diastolic volume of LV was modeled on the basis of the proper stroke index and the contractile ejection fraction (EF). A permissible area of aneurysm resection was calculated by using a difference between the initial and the projected surface area of LV. The patch position and sizes were measured preoperatively. Ventricular reconstruction was performed by using linear plasty in eight patients, septal plasty of the Stoney et al. technique in 14 patients, and endoventriculoplasty of the Dor et al. technique in 19 patients. Results: The mean NYHA functional class decreased from 2.9 ^ 0.6 to 1.6 ^ 0.7 postoperatively. The improvement of LV contracting function made itself evident in a decreased end-diastolic volume from 216 ^ 98 to 158 ^ 35 ml, and end-systolic volume from 133 ^ 85 to 80 ^ 34 ml postoperatively. The mean EF increased from 38 ^ 11 to 49 ^ 9% after operation. We noted that preoperative contractile EF corresponded with postoperative EF (49.8 ^ 11% and 49.3 ^ 9%, respectively). The projected optimal end-diastolic volume of LV estimated before operation agreed with postoperative data (152 ^ 33 ml and 158 ^ 35 ml, respectively). The hospital mortality rate was 7.3%. Conclusions: Preoperative modeling of an optimal LV volume allows for the estimation of a permissible area of aneurysm resection, the position and sizes of the patch, as well as for the prevention of an excessive reduction of the LV cavity after aneurysm repair. q 2001 Elsevier Science B.V. All rights reserved.