Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation

Hirota, Masanori; Katahira, Shintaro; Hoshino, Joji; Fukada, Youichi; Kondo, Taichi; Gyoten, Takayuki; Notomi, Yuichi; Isomura, Tadashi

doi:10.5772/26260

Cited by 2 publications

(5 citation statements)

References 53 publications

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“…We demonstrated that long-term survival rate in patients with smaller postoperative LVESVI was much higher compared with those with larger LV volume. 10,11) Additionally, another report also demonstrated that lower postoperative LVESVI was highly associated with midterm survival. 22,23) Thus, LVESVI less than 100 ml/m 2 would be one of possible predictors for long-term survival in patients with ICM and MR, despite the timing of the operation (preoperative and postoperative).…”

Section: Discussionmentioning

confidence: 97%

“…10,11) The purpose of SVR includes two major reasons such as reduction of LV volume and subvalvular procedures for functional MR. Earlier reports demonstrated that functional MR may result from dilation of the mitral annulus, laterally displaced papillary muscles, and enhanced tethering force of the valve leaflets in the hearts with dilated LV.…”

Section: Discussionmentioning

confidence: 99%

“…10,11) We used three types of SVR, including endoventricular circular patch plasty (EVCPP) for the antero-apical lesion, SAVE for the broad anterior lesion, and posterior restoration procedure (PRP) for the posterior lesion. In addition to SVR, cryoablation was performed for incision line to prevent postoperative ventricular arrhythmia.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…Ischemic myocardial lesion was concomitantly treated by coronary artery bypass grafting including mitral annuloplasty with a one-undersized rigid annuloplasty ring, chordal cutting of the basal chordae, papillary muscle approximation, and chordal translocation. 11) In the early period of the series, MVR was indicated for limited cases.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…10,11) A dilated LV with a focal akinetic lesion is a surgical indication for SVR, and the choice of procedure is determined by the location of the akinesis. Using this surgical strategy, we have treated critical patients with non-ischemic DCM such as muscular dystrophy and cardiac sarcoidosis, and demonstrated operative efficacies.…”

Section: Introductionmentioning

confidence: 99%

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Prediction of Long-Term Survival in Patients with End-Stage Heart Failure Secondary to Ischemic Heart Disease: Surgical Correction and Volumetric Analysis

Yoshida

Hirota

Hoshino

et al. 2015

ATCS

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Purpose: Ischemic heart disease (IHD) may result in lethal conditions such as ischemic cardiomyopathy (ICM) and mitral regurgitation (MR). Methods: We hypothesized preoperative LV volume would be highly associated with longterm survival in such patients. We retrospectively evaluated effects of LV end-systolic volume index (LVESVI) on survival. Results: Patients were divided into two groups according to LVESVI; Group S (n = 19, <100 ml/m 2 ), and L (n = 55, >100 ml/m 2 ). There were 74 patients (male 61, female 13; 61 ± 10 y.o.). There was no statistical significance in preoperative parameters, including ejection fraction (EF), severity of MR, severity of tricuspid regurgitation (TR), and right ventricular systolic pressure (RVSP). After operation, LVESVI and severity of MR were statistically reduced in both groups. However, EF, severity of TR and RVSP were not statistically alleviated in both groups. In Group S, 5-and 10-year survival rates were 93% and 48%. In Group L, 5-and 10-year survival rates were 50% and 29%. There was a statistical difference in long-term survival between two groups. Conclusions: Preoperative LV volume would be one of the risk factors for long-term survival in patients with congestive heart failure secondary to IHD. Careful follow-up and optimal treatment should be recommended before LV dimension becomes too large.

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