Postmyocardial infarction left ventricular dysfunction – Assessment and follow up of patients undergoing surgical ventricular restoration by the endoventricular patchplasty

Abstract

Surgical ventricular restoration in our study has clearly demonstrated a positive effect on LV geometry.

Left Ventricular Reconstruction Surgery in Candidates for Heart Transplantation

“…The surgical ventricular reconstruction (SVR) was described as an effective and efficient technique, regardless of the technique employed [17,18] , allowing patients to have clinical improvement and increased survival, as described by Cooley [5] , Jatene [6] , Dor [7] , Cooley [8] , Michelborough [9] , Dinkhuysen [10] , D’Mello [19] , and Tekümit [20] . Despite the results described, the search for more scientifically consistent information led to multicenter studies, such as that developed by the RESTORE group [11] , which achieved a five-year survival rate of 68.6%, with improvement of the preoperative FC of 67% in class III-IV and 85% in postoperative functional class I-II.…”

Clinical and hemodynamic outcomes of the Dor procedure in adults with ischemic cardiomyopathy

“…Wall motion, often indicated by the wall motion score index (WMSI) is a meaningful variable that can be predictive of poor functional outcomes as well as 1‐year mortality 57 . Wall motion has been reported to improve significantly after SVR and remain consistent for as long as 7 years postoperatively 42,62 . This result has been described after SVR with CABG and after SVR alone, with reverse remodeling continuing for at least several years (27–38 months) 76 …”

“…Many studies have examined dyspnea as a measure of efficacy for SVR and report significant improvement immediately, 6 months, or 1 year postoperatively. 35,37,42,57,58,63,90 However, some studies do report that the significant increase is not always maintained, though it always remains better than baseline. 62 Substantial improvements have been reported regardless of preoperative ventricular shape, 47 extent of postinfarct region septal involvement, 75 and severity of preoperative NYHA class.…”

“…Although the CI is a better predictor of postoperative diastolic dysfunction, reduction in EDV is still a significant benefit of SVR. Many studies have shown that SVR is highly effective in reducing EDV 41–47 . Of note, the amount of volume reduction is highly associated with an increase in chamber wall stiffness, which partially explains the resulting diastolic dysfunction 41 .…”

“…In patients with a previous myocardial infarct, SVR has resulted in significant EF improvements postoperatively, both immediately and/or in longer‐term follow‐up of a year or greater 21,28,36,37,42,46,51,52,55–65 . Although many studies report an increase in EF with continued improvement during follow‐up years, others do report some decline or evidence of remodeling after 18–22 months 61,62 …”