Left Ventricular Reconstruction by Endoventricular Circular Patch plasty Repair: A 17-Year Experience

Dor, Vincent; Donato, Marisa Di; Sabatier, M.; Montiglio, F.; Civaia, Filippo

doi:10.1053/stcs.2001.29966

Cited by 120 publications

(70 citation statements)

References 33 publications

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“…The Surgical Therapy for Ischemic Congestive Heart Failure (STICH) trial is a large, National Institutes of Health-sponsored, multinational trial evaluating surgical therapy, including revascularization, for ischemic cardiomyopathy (102). Similarly, no prospective study has ever shown that left ventricular reconstructive surgery for anterior hypokinesia or akinesia results in either prognostic or symptomatic benefit (103,104). The second primary objective of STICH is to define the role of left ventricular reconstruction in patients undergoing coronary revascularization.…”

Section: Arnold Et Almentioning

confidence: 99%

Canadian Cardiovascular Society consensus conference recommendations on heart failure 2006: Diagnosis and management

Arnold¹,

Liu²,

Demers³

et al. 2006

Canadian Journal of Cardiology

363

256

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Section: Arnold Et Almentioning

confidence: 99%

Canadian Cardiovascular Society consensus conference recommendations on heart failure 2006: Diagnosis and management

Arnold¹,

Liu²,

Demers³

et al. 2006

Canadian Journal of Cardiology

363

256

View full text Add to dashboard Cite

“…When analyzing the survival after 5 years, 82.1 ± 7.2%, it is equal or greater than the majority of the studies [18,20,22,23], so we can affirm that patients who survived surgery presented a very good evolution.…”

Section: Discussionmentioning

confidence: 89%

“…Previous studies performed in single centers [17,18], and multicenter studies [16] have shown excellent results with this technique, both at mid-and long-term.…”

Section: Discussionmentioning

confidence: 99%

Remodelamento reverso cirúrgico do ventrículo esquerdo: seguimento de 111 meses

Almeida¹

2009

Rev Bras Cir Cardiovasc

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“…In patients with ischemic cardiomyopathy and LV aneurysm, LV reconstruction with the technique described by Dor has been shown to be associated with an improved ejection fraction and New York Heart Association functional status. 4 However, completely nonviable and noncontractile LV myocardium with formation of an enormous aneurysm presents a surgical challenge, particularly if LVAD therapy is being considered. A concomitant Dor procedure, which geometrically changes the expanded LV into a more elliptical form, may be necessary in such patients to achieve a stable cannulation site for VAD placement and orientation.…”

Section: Resultsmentioning

confidence: 99%

Combined Surgical Left Ventricular Reconstruction and Left Ventricular Assist Device Implantation for Destination Therapy in End-Stage Heart Failure

Garbade

Bittner

Barten

et al. 2011

Circ: Heart Failure

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E nd-stage heart failure is a growing problem associated with high mortality, using conventional medical care. 1 Although heart transplantation remains the gold standard therapy for end-stage heart failure, it is a limited resource that is not applicable to a large portion of heart failure patients, particularly the elderly. An alternative strategy for patients who do not meet standard heart transplantation criteria is destination therapy with left ventricular assist device (LVAD) implantation. 2 The implantation of nonpulsatile, continuousflow LVADs has become a relatively routine procedure in large surgical centers that is associated with a relatively low complication rate. 3 However, cannulation for LVAD implantation is occasionally challenging. In particular, patients who have undergone a LV restoration and patch volume reduction plasty (ie, "Dor procedure") 4 pose a particular challenge. We describe a favorable 1-year outcome for a severely symptomatic patient with chronic ischemic heart failure and a large LV aneurysm treated by a Dor procedure and simultaneous LVAD implantation. Patient PresentationA 52-year-old patient with ischemic heart failure was referred to our institution for further therapy and possible evaluation for heart transplantation. His medical history was pertinent for heart failure and multiple stenting of the left anterior descending artery. The patient had multiple previous myocardial infarctions resulting in a giant chronic aneurysm of the anterior wall of the LV. The magnetic resonance tomography revealed an excessively dilated LV cavity (end-diastolic volume, 600 mL), a large anterior aneurysm (9.0ϫ3.0ϫ9.5 cm), and a severely compromised LV ejection fraction of 10% (online-only Data Supplement Video). No viable myocardium was observed and revascularization was not indicated. Because of refractory malignant ventricular arrhythmias and a steadily deteriorating clinical situation, LVAD implantation (HeartMate II; Thoratec Corp, Pleasanton, CA) was considered. Because of existing comorbidities, the patient was planned for destination therapy and therefore an extracorporeal LVAD was deemed to be an unsuitable option. Surgical ProcedureAfter full sternotomy, institution of cardiopulmonary bypass, and cross-clamping of the aorta, the LV was fully exposed and mobilized from mild adhesions. The LV aneurysm was opened parallel to the left anterior descending artery and examined for thrombi. A vent was positioned through the pulmonary vein into the LV cavity. An appropriate boundary for endoventricular circular patch repair (Figure, A) was defined between nonviable and healthy myocardium. A new LV chamber was thereafter created, using an oval-shaped Dacron patch as described by Dor 4 (Figure, B). The Dacron patch was secured adjacent to the posterior mitral annulus and directly to the ventricular septum using a 3-0 running Prolene suture. A circular opening was then made in the middle of the oval Dacron patch, and a 28-mm Hemashield graft was sutured to this opening as a T-graft to facilitate ...

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Left Ventricular Reconstruction by Endoventricular Circular Patch plasty Repair: A 17-Year Experience

Cited by 120 publications

References 33 publications

Canadian Cardiovascular Society consensus conference recommendations on heart failure 2006: Diagnosis and management

Canadian Cardiovascular Society consensus conference recommendations on heart failure 2006: Diagnosis and management

Remodelamento reverso cirúrgico do ventrículo esquerdo: seguimento de 111 meses

Combined Surgical Left Ventricular Reconstruction and Left Ventricular Assist Device Implantation for Destination Therapy in End-Stage Heart Failure

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