Estimating postoperative left ventricular volume: Identification of responders to surgical ventricular reconstruction

Abstract

Adding surgical ventricular reconstruction to coronary artery bypass grafting could reduce the mortality risk by increasing ejection fraction for those with a postoperative end-systolic volume index within a specific range. The postoperative end-systolic volume index could demarcate responders to surgical ventricular reconstruction, and its estimation can help in surgical decision making.

The Ultimate Goals of Surgical Ventricular Reconstruction

“…Wakasa et al 5) reported in their retrospective multicenter study that adding SVR to CABG could provide a survival benefit by increasing the LV ejection fraction (LVEF) for those with postoperative LVESVI within a specific range (postoperative LVES-VI of 40 ml/m 2 to 80 ml/m 2 ).…”

The empire strikes back: Surgical ventricular reconstruction works very well in Japan

“…4 To confer an advantage, therefore, surgery must reach a target volume. In this issue of the Journal, Wakasa and coauthors 5 report the results of the Surgical Ventricular Reconstruction for Severe Ventricular Dysfunction registry (SURVIVE). In this multicenter study, 17 different hospitals in Japan collected data for patients with heart failure and left ventricular systolic dysfunction.…”

“…Patients with same volume have different outcomes according to ejection fraction. The goal of Wakasa and coauthors 5 was to identify which patients can respond to the surgery, and they generated 2 equations predicting postoperative volume and ejection fraction.…”

Commentary: Reshaping ventricular geometry of mice and men: How long is the string?

“…First described by Cooley in 1958, surgical ventricular reconstruction promised improvements in LV volumes, ejection fraction, functional class, and even survival. 1,2 Since then, a variety of techniques, with and without cardiopulmonary bypass, have been described. [2][3][4] Onohura and colleagues 5 report the results of an experimental trial of an LV shaping device used in a rat model of ischemic cardiomyopathy.…”

“…1,2 Since then, a variety of techniques, with and without cardiopulmonary bypass, have been described. [2][3][4] Onohura and colleagues 5 report the results of an experimental trial of an LV shaping device used in a rat model of ischemic cardiomyopathy. In their model, ischemic cardiomyopathy was induced via ligation of the coronary artery.…”