A simple method of left ventricular reconstruction without patch for ischemic cardiomyopathy

Caldeira, Christiano; McCarthy, Patrick M.

doi:10.1016/s0003-4975(01)03242-8

Cited by 44 publications

(31 citation statements)

References 3 publications

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“…An associated 60% to 80% life expectancy at 10 years is found with this surgical technique. 1,3,4 In the present series, a modified LV reconstruction technique 3,22 by purse string sutures has shown a similar stable reduction in the LV size at 1 year follow-up. Our results have also shown that LV volume early after surgery is specifically determined intraoperatively by the LV reconstruction procedure.…”

Section: Ii-244 Circulation September 9 2003supporting

confidence: 64%

“…[1][2][3]22 Briefly, the procedure was performed with the use of cardiopulmonary bypass with both antegrade and retrograde cold blood cardioplegia for myocardial protection. Coronary revascularization, when needed, was performed with internal mammary artery and/or saphenous vein grafting in 52 patients (87%), including 11 with 1-vessel disease, 18 with 2-vessel disease and 23 with multivessel disease.…”

Section: Surgical Techniquementioning

confidence: 99%

“…After revascularization and/or MV repair, the cross-clamp was removed and the LV reconstruction was performed on the beating heart for all 60 patients. 22 The LV aneurysm was opened 2 cm left of the left anterior descending artery. A purse-string suture was placed along the border zone into the scarred tissue.…”

Section: Ii-242mentioning

confidence: 99%

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Importance of Mitral Valve Repair Associated With Left Ventricular Reconstruction for Patients With Ischemic Cardiomyopathy: A Real-Time Three-Dimensional Echocardiographic Study

et al. 2003

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Background-Left ventricular (LV) reconstruction surgery leads to early improvement in LV function in ischemic cardiomyopathy (ICM) patients. This study was designed to evaluate the impact of mitral valve (MV) repair associated with LV reconstruction on LV function 1-year after surgery in ICM patients assessed by real-time 3-dimensional echocardiography (3DE). Methods and Results-Sixty ICM patients who underwent the combination surgery (LV reconstruction in 60, MV repair in 30, and revascularization in 52 patients) were studied. Real-time 3DE was performed and LV volumes were obtained at baseline, discharge, 6-month and Ն12-month follow-up. Reduction in end-diastolic volumes (EDV) by 29% and in end-systolic volumes by 38% were demonstrated immediately after surgery and remained at subsequent follow-up (PϽ0.0001). The LV ejection fraction significantly increased by about 10% at discharge and was maintained Ն12-month (PϽ0.0001). Although the LV volumes were significantly larger in patients with MV repair before surgery (EDV, 235Ϯ87 mL versus 193Ϯ67 mL, PϽ0.05), they were similar to LV volumes of the patients without MV repair at subsequent follow-ups. However, the EDV increased from 139Ϯ24 mL to 227Ϯ79 mL (PϽ0.01) in 7 patients with recurrent mitral regurgitation (MR). Improvement in New York Heart Association functional class occurred in 81% patients during late follow-up. Conclusion-Real-time 3DE demonstrates that LV reconstruction provides significant reduction in LV volumes and improvement in LV function which is sustained throughout the 1-year follow-up with 84% cardiac event free survival. If successful, MV repair may prevent LV redilation, while recurrent MR is associated with increased LV volumes.

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Section: Ii-244 Circulation September 9 2003supporting

confidence: 64%

Section: Surgical Techniquementioning

confidence: 99%

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Importance of Mitral Valve Repair Associated With Left Ventricular Reconstruction for Patients With Ischemic Cardiomyopathy: A Real-Time Three-Dimensional Echocardiographic Study

et al. 2003

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“…Later, the procedure was adopted by many skilled and creative surgeons without real standardization, making results difficult to compare. McCarthy described a no-patch, double purse-string suture technique [19]; Mickleborough described a tailored scar excision, with septoplasty when indicated for dyskinetic septum, and modified linear closure [20]; Menicanti adopted a technique that is similar to the Dor procedure except for the use of a pre-shaped mannequin (TRISVR TM , Chase Medical Richardson, TX), which is illustrated in Fig. (1) [21].…”

Section: Svr Techniquementioning

confidence: 99%

Surgical Ventricular Restoration to Reverse Left Ventricular Remodeling

Castelvecchio¹,

Menicanti²,

Donato³

2009

CCR

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Heart failure is one of the major health care issues in the Western world. An increasing number of patients are affected, leading to a high rate of hospitalization and high costs. Even with administration of the best available medical treatment, mortality remains high. The increase in left ventricular volume after a myocardial infarction is a component of the remodeling process. Surgical Ventricular Restoration (SVR) has been introduced as an optional therapeutic strategy to reduce left ventricular volume and restore heart geometry. So far, it has been established that SVR improves cardiac function, clinical status, and survival in patients with ischemic, dilated cardiomyopathy and heart failure. Since its first description , SVR has been refined in an effort to standardize the procedure and to optimize the results. This review will discuss the rationale behind surgical reversal of LV remodeling, the SVR technique, its impact on cardiac function and survival, and future expectations.

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“…Caldeira and McCarthy use a double purse-string suture technique without a patch. 26 Mickleborough et al reported the efficacy of linear closure and septoplasty. 27 Isomura et al demonstrated the superiority of the SAVE procedure in terms of obtaining a more ellipsoid LV shape.…”

Section: Study Limitationsmentioning

confidence: 99%

Long-Term Results of Left Ventricular Reconstructive Surgery in Patients With Ischemic Dilated Cardiomyopathy

Takeda

Matsumiya

Sakaguchi

et al. 2008

Circ J

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urgical treatment of congestive heart failure associated with myocardial infarction (MI) is attracting much attention because its prognosis is still poor despite recent improvements in medical treatment. 1 Post-MI left ventricular (LV) remodeling is characterized by chamber dilatation and abnormal geometric change, which leads to heart failure progressing to ischemic cardiomyopathy. Heart transplantation is widely accepted as the optimal surgical therapy for heart failure patients, including those associated with ischemic etiology, but unfortunately transplantation is limited by the lack of donors and many exclusion criteria such as age and end-organ dysfunction. As an alternative surgical therapy, Dor at el introduced endoventricular circular patch plasty for patients with ischemic cardiomyopathy that has developed after a large anteroseptal MI. 2 Several modifications of LV restoration (LVR) have been proposed and some retrospective data, including largescale studies, have shown safety and efficacy in terms of survival benefit and LV functional recovery. 3,4 Moreover, there is an ongoing multicenter, randomized, international trial (Surgical Treatment for Ischemic Heart Failure trial) to elucidate the real benefits of LVR. 5 However, there are only limited data about the long-term results of LVR in Japan. Furthermore, because of a specific situation related to the severely limited supply of organ donors and the limited availability of cardiac support devices, such as the ventricular assist system, 6 we have adopted liberal inclusion criteria for LVR, even for critically ill patients who are generally treated with mechanical circulatory support and subsequent heart transplantation. 7 Consequently, it is meaningful to examine our own experiences of LVR.We conducted a multicenter retrospective study to analyze the long-term outcomes of LVR and examine its efficacy and limitations. Methods PatientsFour university-affiliated hospitals participated in the study. Ethical committee approval was obtained in each institution. We retrospectively reviewed 72 patients who underwent LVR from January 1999 to June 2007. All patients included in the analysis had preoperative global LV dysfunction (LV ejection fraction (EF) <40%) and significantly enlarged LV (end-systolic volume index (ESVI) Received April 18, 2008; revised manuscript received June 9, 2008; accepted June 17, 2008; released online September 18, 2008 Background Left ventricular restoration (LVR) is increasingly used for treatment of chronic heart failure following myocardial infarction. The present multi-institutional retrospective study analyzed the long-term efficacy and limitations of LVR. Methods and Results Seventy-two (58 males, mean age 62±10) patients who underwent LVR between January 1999 and June 2007 were included. Preoperatively, 50 (68.5%) were in New York Heart Association (NYHA) functional class III or IV. Mean left ventricular end-diastolic and end-systolic volume indexes were 145±43 ml/m 2 and 111±40 ml/m 2 , respectively, and ejection fraction...

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A simple method of left ventricular reconstruction without patch for ischemic cardiomyopathy

Cited by 44 publications

References 3 publications

Importance of Mitral Valve Repair Associated With Left Ventricular Reconstruction for Patients With Ischemic Cardiomyopathy: A Real-Time Three-Dimensional Echocardiographic Study

Importance of Mitral Valve Repair Associated With Left Ventricular Reconstruction for Patients With Ischemic Cardiomyopathy: A Real-Time Three-Dimensional Echocardiographic Study

Surgical Ventricular Restoration to Reverse Left Ventricular Remodeling

Long-Term Results of Left Ventricular Reconstructive Surgery in Patients With Ischemic Dilated Cardiomyopathy

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