Clinical and hemodynamic outcomes of the Dor procedure in adults with ischemic cardiomyopathy

Hassanabad, Ali Fatehi; Wiebe, Kiana; Ali, Imtiaz S.

doi:10.1111/jocs.15968

Cited by 5 publications

(5 citation statements)

References 112 publications

(472 reference statements)

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“…Although our center has a large amount of experience in this field, data collection suffered from missing information, including the total number of previous PCI, which could have affected changes in LV remodeling as well as the presentation of the patients. On the other side, the released STICH results in March 2009 have undoubtedly affected the decision to refer a patient for SVR, but the same results pushed expert surgeons to reconsider the indications [17].…”

Section: Discussionmentioning

confidence: 99%

Surgical Ventricular Restoration for Ischemic Heart Failure: A Glance at a Real-World Population

Castelvecchio

Milani

Ambrogi

et al. 2022

JPM

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Surgical ventricular restoration (SVR) has repeatedly been suggested as a viable therapeutic strategy for ischemic heart failure (HF) patients, although the survival benefit is still debated. We investigated a real-world population treated with SVR in a single center with high case volumes. From July 2001 to June 2017, 648 patients (111 females) underwent SVR; coronary surgery was performed in 582 patients. Data were analyzed by dividing the population into two groups: Group I (371 patients operated between July 2001 and December 2007) and Group II (277 patients operated between January 2008 and June 2017). At baseline, Group I patients were more symptomatic for angina (47.4% versus 19.4%, p < 0.0001) and less symptomatic for HF (NYHA class III/IV, 46.3% versus 57%, p = 0.0071). The end-diastolic volume (106 mL/m2 versus 118.3 mL/m2, p < 0.0001) and the end-systolic volume (70.5 mL/m2 versus 81.5 mL/m2, p < 0.0001) were lower in Group I. The presence of 3-vessel coronary artery disease (CAD) was higher in Group I (73.3% versus 59.2%, p < 0.0001). Thirty-day mortality (6.64%) was similar in the two groups (p = 0.4475). The Kaplan–Meier estimate for all-cause mortality for the entire population was 13% at 2 years, 19.2% at 4 years and 36.6% at 8 years, and the probability was not different between groups (Log-rank = 0.11). In a real-world ischemic HF population, SVR may be carried out with favorable results; in patients with worse LV remodeling and less extensive CAD, SVR showed a trend toward a better outcome.

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Section: Discussionmentioning

confidence: 99%

Surgical Ventricular Restoration for Ischemic Heart Failure: A Glance at a Real-World Population

Castelvecchio

Milani

Ambrogi

et al. 2022

JPM

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“…Surgical ventricular restoration (SVR) is another alternative surgical option for ICM patients. SVR often includes endo-ventricular circular patch plasty (EVCPP), also known as the Dor procedure in its original or its modified form, and CABG with or without mitral valve intervention [45]. SVR can be performed in a specific group of patients that meet specific selection criteria.…”

Section: Surgical Ventricular Restorationmentioning

confidence: 99%

Surgical Management of Ischemic Cardiomyopathy Patients with Severe Left Ventricular Dysfunction: Is It Time to Reconsider Revascularization Surgery?

Masroor,

Wang,

Zhang

et al. 2024

JCDD

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Ischemic cardiomyopathy patients with severe left ventricular dysfunction are a specific group of patients with poor surgical outcomes. There are few surgical treatment options in practice for the treatment of these patients such as heart transplantation, coronary artery bypass surgery, surgical ventricular restoration, etc. Despite multiple treatment options, there are no explicit clinical guidelines available to guide surgeons in choosing the most appropriate option and ensuring that the specific patient can benefit from the selected surgical treatment. Heart transplantation is the gold standard treatment for ischemic cardiomyopathy patients with severe left ventricular dysfunction, but it is limited to very few highly equipped centers around the world due to donor shortages, complex perioperative and surgical management, and limited technological and human resources. It is evident from some studies that heart transplant-eligible candidates can benefit from alternative surgical options such as coronary artery bypass surgery alone or combined with surgical ventricular restoration. Therefore, alternative surgical options that are used for most of the population, especially in developing and underdeveloped countries, need to be discussed to improve their outcomes. A challenge in the recent era which has yet to find a solution is to determine which heart transplant candidate can benefit from simple revascularization compared to a complex heart transplantation procedure. Myocardial viability testing was one of the most important determinants in deciding whether a patient should undergo revascularization, but its role in guiding appropriate surgical options has been challenged. This review aims to discuss the available surgical management options and their long-term outcomes for patients with ischemic cardiomyopathy, which will eventually help surgeons when choosing a surgical procedure.

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“…Surgical ventricular restoration to reshape the markedly dilated LV and collapse the large aneurysm would facilitate regenerative therapy ( 41 ). In fact, surgical ventricular restoration has repeatedly been suggested as a viable alternative in managing heart failure in select patients with a large LV and refractory heart failure, as it is believed that surgically returning the ventricle to its original dimensions is possible and is associated with favorable outcomes ( 79 ). It may be feasible to generate a murine model with a smaller infarct size using absorbable suture ligation, which would facilitate regenerative studies after CTO recanalization.…”

Section: The Feasibility Of Cardiac Regeneration After Chronic Total ...mentioning

confidence: 99%

Revascularization of chronic total occlusion coronary artery and cardiac regeneration

Liao

Wang

et al. 2022

Front. Cardiovasc. Med.

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Coronary chronic total occlusion (CTO) contributes to the progression of heart failure in patients with ischemic cardiomyopathy. Randomized controlled trials demonstrated that percutaneous coronary intervention (PCI) for CTO significantly improves angina symptoms and quality of life but fails to reduce clinical events compared with optimal medical therapy. Even so, intervening physicians strongly support CTO-PCI. Cardiac regeneration therapy after CTO-PCI should be a promising approach to improving the prognosis of ischemic cardiomyopathy. However, the relationship between CTO revascularization and cardiac regeneration has rarely been studied, and experimental studies on cardiac regeneration usually employ rodent models with permanent ligation of the coronary artery rather than reopening of the occlusive artery. Limited early-stage clinical trials demonstrated that cell therapy for cardiac regeneration in ischemic cardiomyopathy reduces scar size, reverses cardiac remodeling, and promotes angiogenesis. This review focuses on the status quo of CTO-PCI in ischemic cardiomyopathy and the clinical prospect of cardiac regeneration in this setting.

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Clinical and hemodynamic outcomes of the Dor procedure in adults with ischemic cardiomyopathy

Cited by 5 publications

References 112 publications

Surgical Ventricular Restoration for Ischemic Heart Failure: A Glance at a Real-World Population

Surgical Ventricular Restoration for Ischemic Heart Failure: A Glance at a Real-World Population

Surgical Management of Ischemic Cardiomyopathy Patients with Severe Left Ventricular Dysfunction: Is It Time to Reconsider Revascularization Surgery?

Revascularization of chronic total occlusion coronary artery and cardiac regeneration

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