Quality of Life after 114 Months of Follow-up following Geometric Reconstruction of the Left Ventricle by Endoventriculoplasty with Septal Exclusion

Almeida, Rui

doi:10.1532/hsf98.20091132

HSF

2010

DOI: 10.1532/hsf98.20091132

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Quality of Life after 114 Months of Follow-up following Geometric Reconstruction of the Left Ventricle by Endoventriculoplasty with Septal Exclusion

Rui Almeida¹

Abstract: EVSE surgery is an effective option for treating this group of patients, with improvement noted in left ventricular function and in the patients' quality of life, despite the high in-hospital mortality.

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Surgical approaches to left ventricular reconstruction: a matter of perspective

Doenst

2012

Heart Fail Rev

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Surgical reconstruction of physiological shape and size of a postischemically remodeled left ventricle has been advocated to improve ventricular function and improve patient long-term outcome. What initially started as linear aneurysm resection surgery developed over the years into the endoventricular repair techniques (surgical ventricular reconstruction, SVR) that have also been applied in patients with postischemically dilated ventricles and mainly anterior akinesia. SVR improved function as measured by the ejection fraction. Whether it affects survival was finally tested in the largest surgical trial ever conducted, the STICH trial (Surgical Treatment for IsChemic Heart failure). The trial, however, presented rather sobering information with its Hypothesis 2 outcome by demonstrating identical 5-year survival rates between SVR plus bypass grafting (CABG) and CABG alone. SVR also did not improve quality of life. This neutral finding spawned a series of critical responses with respect to trial design and conduct accompanied by appropriate responses by the trial's leadership. At the end of this dispute, it appears that SVR has been accepted as not very useful for most patients and is less and less performed in daily practice. What remains is a series of different perspectives that will be discussed in this review. The conclusion will be that SVR may be of low value for the patient with dilated and massively remodeled ventricles, but the technique bears therapeutic potential for some patients for different reasons so that the surgeon's ability to perform this operation should not get lost.

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Surgical approaches to left ventricular reconstruction: a matter of perspective

Doenst

2012

Heart Fail Rev

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Current World Literature

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Current Opinion in Anaesthesiology

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Current World Literature

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Quality of Life after 114 Months of Follow-up following Geometric Reconstruction of the Left Ventricle by Endoventriculoplasty with Septal Exclusion

Abstract: EVSE surgery is an effective option for treating this group of patients, with improvement noted in left ventricular function and in the patients' quality of life, despite the high in-hospital mortality.

Cited by 3 publications

References 23 publications

Surgical approaches to left ventricular reconstruction: a matter of perspective

Surgical approaches to left ventricular reconstruction: a matter of perspective

Current World Literature

Current World Literature

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