Overlapping cardiac volume reduction operation

Matsui, Yoshiro; Fukada, Youichi; Suto, Yukio; Yamauchi, H.; Luo, Bin; Miyama, Masatoshi; Sasaki, Shigeyuki; Tanabe, T.; Yasuda, Keishu

doi:10.1067/mtc.2002.123616

Cited by 35 publications

(30 citation statements)

References 5 publications

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“…The patients who had a large LV (LVDd ≥65 mm) with a large scar lesion were indicated for left ventriculoplasty (stage 3) to exclude scar lesions, reduce the LV volume, and restore the LV shape. Overlapping left ventriculoplasty 7) or partial left ventriculectomy 8) was selected for an anteroseptal or inferoposterior scar lesion, respectively. Coronary artery bypass grafting (CABG) was performed if the patient had untreated and significant coronary lesions.…”

Section: Assessment Of Cardiac Parametersmentioning

confidence: 99%

Surgical Strategy for Ischemic Mitral Regurgitation Adopting Subvalvular and Ventricular Procedures

Wakasa

Shingu

Ōoka

et al. 2015

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Purpose: The progression of left ventricular (LV) remodeling and subsequent mitral valve tethering impair the results of reduction annuloplasty for ischemic mitral regurgitation (MR). Methods: We studied 90 patients who underwent surgical repair of ischemic MR between 1999 and 2013 according to our surgical strategy adding submitral and ventricular procedures to annuloplasty as follows: annuloplasty alone (stage 1, n = 30), additional papillary muscle approximation (PMA) for progression of tethering (stage 2, n = 26), and additional left ventriculoplasty with PMA for progression of LV remodeling and tethering (stage 3, n = 34). Results: The preoperative New York Heart Association (NYHA) functional classes (2.5 ± 0.7, 3.1 ± 0.7 and 3.3 ± 0.7 for stages 1, 2 and 3, respectively, P <0.001), LV end-diastolic diameters (56 ± 7 mm, 66 ± 5 mm and 70 ± 7 mm, P <0.001), and LV ejection fractions (45 ± 12%, 32 ± 9% and 27 ± 9%, P <0.001) significantly differed among the stages. In contrast, the MR grades did not significantly differ (2.9 ± 0.8, 3.0 ± 1.0, and 2.9 ± 1.1, respectively; P = 0.93). Both the rates of cardiac-related survival and freedom from reoperation were comparable among the 3 groups (log-rank P = 0.92 and 0.58, respectively). Conclusion: Additional submitral and ventricular procedures can compensate for the possible impairment of the outcomes after annuloplasty alone for ischemic MR in patients with severe LV remodeling and tethering.

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Section: Assessment Of Cardiac Parametersmentioning

confidence: 99%

Surgical Strategy for Ischemic Mitral Regurgitation Adopting Subvalvular and Ventricular Procedures

Wakasa

Shingu

Ōoka

et al. 2015

ATCS

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“…4,5) We developed a new procedure in this field named Overlapping Left Ventriculoplasty in 2001. 6) As an adjunctive procedure, papillary muscle approximation (PMA) was introduced to overcome the mitral valve tethering which caused functional mitral regurgitation. 7) To consider the effect of OLVP on the LV function with excluding the benefit of surgical revascularization, we compared the regional wall thickening between OLVP + PMA of NICM group and PMA of NICM group.…”

Section: Discussionmentioning

confidence: 99%

“…We also reported our techniques of SVR including left ventriculoplasty with overlapping technique (OLVP) and repair of mitral valve tethering with mitral valve ring annuloplasty (MAP), papillary muscle approximation (PMA). 6,7) Recently, the effectiveness of SVR was reported by evaluating postoperative clinical status of heart failure as NYHA classification or global LV function such as ejection fraction, LV diastolic and systolic dimensions and so on. 8,9) Conversely, the benefit of SVR and the influence of correction of mitral regurgitation for ICM patients were disallowed, reported from a megastudy 10) or from a high-volume center.…”

Section: Introductionmentioning

confidence: 99%

Surgical Ventricular Restoration Improves the Left Ventricle Basal Wall Function Using Quantitative Gated Spect

Kubota

Matsui

Wakasa

et al. 2011

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Objective: It is not clear whether surgical ventricular restoration (SVR) or procedures approaching mitral complex for controlling functional mitral regurgitation (MR) affect the regional left ventricular wall function. The purpose of the present study was to evaluate the regional LV function after SVR using overlapping left ventriculoplasty (OLVP) using quantitative gated myocardial perfusion SPECT (QGS). Patients and Method: Forty-one heart failure patients, including those with ischemic cardiomyopathy (ICM) (n = 25) and non-ICM (NICM) (n = 16), underwent SVR and/or papillary muscle approximation (PMA). The rest myocardial perfusion SPECT were performed before and early after operation (mean 25.8 ± 10.6 days). These patients were divided into 4 groups based on the surgical procedures (SVR and/or PMA) and etiology of patients (ICM or NICM) as follows: SVR (with or without PMA) of ICM, SVR of NICM, PMA of ICM and PMA of NICM groups. The regional wall thickening was compared before and after the operation between the four groups. Results: NYHA functional classes were improved after the operation in all four groups. MR grade was also improved in three groups other than SVR of the ICM group. The left ventricular basal wall thickening was improved postoperatively in following three groups (SVR of ICM: 12.7 ± 3.8% to 16.5 ± 4.6% p <0.05, PMA of ICM: 11.1 ± 4.3% to 14.9 ± 4.8% p <0.05, SVR of NICM: 5.8 ± 6.6% to 12.3 ± 6.4% p <0.05), whereas PMA of the NICM group did not show an improvement. Wall thickening in the middle and distal levels was not improved in all groups. Conclusion: OLVP improved NYHA functional classes, and also improved the regional wall function at the basal level of the left ventricle. In contrast, lone PMA did not improve or impair the regional wall function at any of the levels.

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“…3F). Some patients requiring SAVE were treated by overlapping cardiac volume reduction operations in this series 32) . c. Posterior restoration procedure (PRP) The posterior akinetic region of the LV was repaired with the PRP procedure developed by Isomura et al 24) .…”

Section: Technical Details Of Our Three Svr Procedures For Icmmentioning

confidence: 99%

Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation

Hirota¹,

Katahira²,

Hoshino³

et al. 2012

Front Lines of Thoracic Surgery

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Overlapping cardiac volume reduction operation

Cited by 35 publications

References 5 publications

Surgical Strategy for Ischemic Mitral Regurgitation Adopting Subvalvular and Ventricular Procedures

Surgical Strategy for Ischemic Mitral Regurgitation Adopting Subvalvular and Ventricular Procedures

Surgical Ventricular Restoration Improves the Left Ventricle Basal Wall Function Using Quantitative Gated Spect

Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation

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