Importance of preserving the apex and plication of the base in left ventricular volume reduction surgery

Koyama, Tadaaki; Nishimura, Kazunobu; Soga, Yoshiharu; Unimonh, Oriyanhan; Ueyama, Koji; Komeda, Masashi

doi:10.1067/mtc.2003.54

Cited by 29 publications

(25 citation statements)

References 18 publications

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“…When an LV lesion is detected before operation and it is located at the posterolateral wall, as seen in muscular dystrophy, 68 the PLV seems to be an effective procedure for nonischemic DCM. 69,70 The operative results improved with the selection of the procedures, with elective operation, and mitral plasty for less cardiac dilatation. 71 The mid-term results of clinical status and LV function showed the effectiveness of the operation.…”

Section: Site Selection For Svrmentioning

confidence: 96%

Surgical left ventricular reconstruction

Isomura¹

2011

Gen Thorac Cardiovasc Surg

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Because of the shortage of donors for heart transplantation, surgical ventricular reconstruction (SVR) has been under development to treat end-stage heart failure due to a dilated left ventricle. The operative procedures have been developed and modified based on the clinical results and preoperative findings of several examinations. SVR is performed to reduce the size and volume of the ventricle as well as to reshape it. The procedures, which differ based on the particular left ventricular lesion, are endoventricular patch plasty or septal anterior ventricular restoration for anteroseptal exclusion and partial left ventriculectomy or a posterior restoration procedure for posterolateral exclusion. In the indicated patients, SVR has been emerging as an alternative to heart transplantation. The accumulating surgical knowledge may provide new opportunities for the treatment of ischemic dilated cardiomyopathy. The Surgical Treatment for Ischemic Heart Failure (STICH) trial seems to have arrived at a misguided conclusion. Surgeons have to know not only the operative procedures for SVR; they must also be aware of the systolic and diastolic functioning and the volume and size of the left ventricle before and after SVR. Hence, SVR is reviewed and discussed here.

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Section: Site Selection For Svrmentioning

confidence: 96%

Surgical left ventricular reconstruction

Isomura¹

2011

Gen Thorac Cardiovasc Surg

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“…Although initial reports on the Batista procedure lacked significant information on its safety and effectiveness, the overall clinical impression was that the operation may serve as a bridge to HT especially in patients with idiopathic dilated cardiomyopathy. Komeda and Koyama reported animal studies that confirmed that apical sparing volume reduction surgery improved the outcome [3]. With good initial results published (Cleveland, Bristol, Japan, Sao Paulo, Belgrade) [4][5][6][7][8], clinicians were enthusiastic about the potential benefits of this surgery returning patients to a normal lifestyle without the long-term complications and cost related to immunosuppression and HT, and even more centers started the program.…”

Section: Introductionmentioning

confidence: 94%

Auswirkung der Batista-Operation auf die Chirurgie der terminalen Herzinsuffizienz

Gradinac

2004

Eur Surg

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Auswirkung der Batista-Operation auf die Chirurgie der terminalen Herzinsuffizienz Zusammenfassung. Grundlagen: Die Chirurgie der dilatativen, nicht-ischämischen Kardiomyopathie ist im Gegensatz zur Herztransplantation ein neues Spektrum der Herzchirurgie. In den letzten 8 bis 9 Jahren ist die partielle linksventrikuläre Ventrikulektomie (PLV) mit viel Enthusiasmus aufgetaucht, führte aber zu enttäuschenden Ergebnissen.Methodik: Wegen den nicht zufrieden stellenden ersten Ergebnissen wird die PLV heute selten angewandt. Es gíbt jedoch einige Beispiele mit deutlich verbessertem klinischen Status und verbesserter linksventrikulärer Funktion.Ergebnisse: Unterschiedliche Zugänge zur PLV aus unterschiedlichen Ländern und Zentren haben die Methode modifiziert und führen zu unterschiedlichen Ergebnissen.Schlussfolgerungen: Die PLV wird noch immer durchgeführt, braucht aber mehr Studien und Verbesserungen. Die zugrunde liegende Idee, dem linken Ventrikel seine normale Form zu geben, lässt andere Methoden zur Chirurgie der Herzinsuffizienz entstehen.Schlüsselwörter: Herzinsuffizienz, partielle Ventrikulektomie, Batista-Operation.Summary. Background: In contrast to transplantation, surgical treatment of nonischemic dilated cardiomyopathy (CMP) is a new field in cardiac surgery. In the past 8 or 9 years, partial left ventriculectomy (PLV) has emerged with initial enthusiasm but its results were disappointing.Methods: We analyzed our own and collective data on PLV.Results: Due to unsatisfactory initial results, PLV is presently rarely used. There are, however, several cases of improvement of clinical status and ventricular function following the procedure. Quite different approaches to PLV from different countries and centers that have performed and modified the procedure in this period have led to different outcomes.Conclusions: After fluctuations, PLV is still viable and needs more research and refinements. The very idea of restoring the left ventricle to its normal shape has facilitated the emergence of other procedures involved in heart failure surgery.

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“…Therefore, we need to downsize those dilated ventricles appropriately. Because we found a nonhomogeneous severity of interstitial fibrosis between the left ventricular free wall and the septum in idiopathic dilated cardiomyopathy [10,11], we introduced surgical exclusion site selection for the left ventriculoplasty procedure, which is the septal anterior ventricular exclusion (SAVE) [12] for bad septum cases and the modified partial left ventriculectomy (PLV) [13] when the lateral wall is the weakest part.…”

Section: Introductionmentioning

confidence: 99%