Effects of Surgical Ventricular Reconstruction and Mitral Complex Reconstruction on Cardiac Oxidative Metabolism and Efficiency in Nonischemic and Ischemic Dilated Cardiomyopathy

Abstract

Combined surgery with SVR and mitral complex reconstruction reduced LV volume in association with improvement of cardiac efficiency in patients with severe heart failure.

Surgical Ventricular Reconstruction for Heart Failure

“…In the current study by Sugiki et al (12), 7 of 12 patients (58%) received standard medical therapy for heart failure in terms of beta-blockers and angiotensin receptor blockers (ARBs), but 42% did not: 2 patients did not receive beta-blockers, 2 patients did not receive ARBs, and 1 patient did not receive either a beta-blocker or an ARB. Spironolactone was also not consistently used.…”

“…Several caveats are warranted in interpreting the oxidative metabolism results reported by Sugiki et al (12). As noted by the authors, their sample size was small (N ϭ 12), especially considering the subgrouping of patients according to ischemic and nonischemic etiologies, and larger numbers of patients will be needed to draw meaningful conclusions and support these preliminary positive findings.…”

“…In this issue of iJACC, Sugiki et al (12) provide further unique information regarding the functional results of the OLVP method of SVR. Using a combination of echocardiography and positron emission tomography (PET), the investigators studied LV function, volume, and mass along with assessment of oxidative metabolism using carbon-11 acetate.…”

Imaging of Myocardial Oxidative Metabolism in Heart Failure

“…Kmono before and after surgery (b) and C-11 acetate imaging (early phase) of short-axis view in the midlevel before and after surgery (c). Kmono value did not change, whereas left ventricular size decreased after surgery [43••]…”

Dilated Phase of Hypertrophic Cardiomyopathy Caused by Two Different Sarcomere Mutations, Treated with Surgical Left Ventricular Reconstruction and Cardiac Resynchronization Therapy with a Defibrillator

“…In addition, SVR not only improves the ventricular function, but also improves the long-term outcome (26). The overlapping left ventriculoplasty, which is a modified SVR procedure, reduces the LV volume and reshapes the left ventricle in association with improvement of the cardiac efficiency in DCM patients with severe heart failure and ischemic heart disease (27). We therefore decided to perform SVR with an overlapping technique and mitral valve plasty.…”