Beneficial effects of endoventricular circular patch plasty in patients with left ventricular systolic dysfunction and left ventricular dyskinetic or akinetic apical segment

Abstract

Background: Available data on the efficiency of endoventricular circular patch plasty (EVCPP) especially from Asian Indians are limited. The objective of the present investigation was to evaluate the efficacy of endoventricular circular patch plasty along with coronary artery bypass grafting (CABG). Methods: Patients having ischemic left ventricular (LV) systolic dysfunction [LV ejection fraction (LVEF)<25%] with left ventricular dyskinetic or akinetic apical segement [as depicted by two dimensional (2D) echocardiography] were enrolled in the study. They were evaluated for 2D echocardiography and colorDoppler parameters as well as functional capacity before surgery and after one, three and six months of surgery.Results: 39 patients (35 males; average age 59 years) were enrolled in the study. There was significant (P<0.05) increase in LV contractility measured in terms of LVEF with absolute rise of 8-14 digits from presurgery levels during time course of the study. EVCPP performed in addition to CABG produced significant reduction in LV end diastolic diameter (5-5.5 mm) and LV end systolic diameter (4.5-8.5 mm) at short-and intermediate-term following surgery. EVCPP plus CABG also produced significant improvement in functional capacity as a significant decrease in New York Heart Association class for heart failure was observed at all three stages of follow-up after surgery.Conclusion: EVCPP carried out along with CABG produces significant improvement in LV contractility, in reverting LV remodeling and functional status in Indian patients with LV systolic dysfunction and LV dyskinetic or akinetic apical segment at shor-term as well as intermediate-term following surgery. (Ind J Thorac Cardiovasc Surg, 2007; 23: [16][17][18][19][20][21][22][23][24]