Ventricular Reconstruction Results in Improved Left Ventricular Function and Amelioration of Mitral Insufficiency

Kaza, Aditya K.; Patel, Mayank R.; Fiser, Steven M.; Long, Susan K. De; Kern, John A.; Tribble, Curtis G.; Krön, Irving L.

doi:10.1097/00000658-200206000-00010

Cited by 36 publications

(23 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…39 The partial ventriculectomy stress-reduction experience reminded surgeons that decreasing inter-PM separation could cause variable tethering, prolapse, and severe MR unless prevented by an edge-to-edge (Alfieri) stitch. More recent ventricular reconstruction approaches championed by investigators such as Gerald Buckberg and Lynda Mickleborough, as in the STICH trial (Surgical Treatments for Ischemic Heart Failure), restore a less spherical ventricle to optimize contraction and reduce MR. [72][73][74][75] Dor's excision and patching of large dysfunctional areas reduces MR, but tethering and MR may recur. 76 Tethering can be reduced by infarct plication to reduce bulging, reported by Liel-Cohen et al 31 (Figure 8).…”

Section: Therapymentioning

confidence: 99%

Ischemic Mitral Regurgitation on the Threshold of a Solution

2005

View full text Add to dashboard Cite

Section: Therapymentioning

confidence: 99%

Ischemic Mitral Regurgitation on the Threshold of a Solution

2005

View full text Add to dashboard Cite

“…In our study, the significant decrease in MR-grade on short-term (one month) of surgery suggested the beneficial effect of EVCPP on MR. This is supported by Kaza et al (2002) 46 and Gorman et al (2003) 44 studies which reported that ventricular reconstruction procedure ameliorates MR even in the absence of associated mitral valve procedures, probably due to reduction in the size of the ventricle and improved orientation of the papillary muscles. However, chronic and severe LV dysfunction induced MR can not be restored by treatment of CAD in absence of adjuvant mitral valve surgery 44 .…”

Section: Discussionmentioning

confidence: 71%

Beneficial effects of endoventricular circular patch plasty in patients with left ventricular systolic dysfunction and left ventricular dyskinetic or akinetic apical segment

Jain

Mallya

Gupta

et al. 2007

Indian J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Background: Available data on the efficiency of endoventricular circular patch plasty (EVCPP) especially from Asian Indians are limited. The objective of the present investigation was to evaluate the efficacy of endoventricular circular patch plasty along with coronary artery bypass grafting (CABG). Methods: Patients having ischemic left ventricular (LV) systolic dysfunction [LV ejection fraction (LVEF)<25%] with left ventricular dyskinetic or akinetic apical segement [as depicted by two dimensional (2D) echocardiography] were enrolled in the study. They were evaluated for 2D echocardiography and colorDoppler parameters as well as functional capacity before surgery and after one, three and six months of surgery.Results: 39 patients (35 males; average age 59 years) were enrolled in the study. There was significant (P<0.05) increase in LV contractility measured in terms of LVEF with absolute rise of 8-14 digits from presurgery levels during time course of the study. EVCPP performed in addition to CABG produced significant reduction in LV end diastolic diameter (5-5.5 mm) and LV end systolic diameter (4.5-8.5 mm) at short-and intermediate-term following surgery. EVCPP plus CABG also produced significant improvement in functional capacity as a significant decrease in New York Heart Association class for heart failure was observed at all three stages of follow-up after surgery.Conclusion: EVCPP carried out along with CABG produces significant improvement in LV contractility, in reverting LV remodeling and functional status in Indian patients with LV systolic dysfunction and LV dyskinetic or akinetic apical segment at shor-term as well as intermediate-term following surgery. (Ind J Thorac Cardiovasc Surg, 2007; 23: [16][17][18][19][20][21][22][23][24]

show abstract

“…Others have reported a perioperative mortality rate of 6.6 % and an overall 18-month survival rate of 89 % after surgery [ 151 ]. The procedure appears to reduce mitral regurgitation in a majority of patients even when no associated mitral valve procedure is done, probably secondary to reduction in ventricle size and reorientation of the papillary muscles [ 152 ].…”

Section: Dor Proceduresmentioning

confidence: 94%

Surgical Treatment of Advanced Heart Failure

Mallidi

Cohn

Frazier

2015

Coronary Artery Disease

View full text Add to dashboard Cite

Improved medical therapy is enabling a growing number of patients to survive previously fatal cardiovascular conditions, but many of these patients later succumb to advanced heart failure. Cardiac transplantation is an established surgical treatment option for advanced heart failure, but despite expansion of the criteria for donor selection, the number of hearts available for transplantation remains limited. Mechanical circulatory support with left ventricular assist devices is being used both as a bridge to transplantation and as destination therapy, and it may promote recovery of cardiac function in patients with advanced heart failure. Attempts to develop a transcutaneously powered total artifi cial heart are ongoing. Other treatments under investigation include surgical restoration of the left ventricular wall (Dor procedure) and passive left ventricular reshaping to reverse ventricular dilation, thereby preventing further myocardial cell death, and allowing hypertrophied cardiac cells to resume normal function. Mitral valve repair or replacement for severe secondary mitral regurgitation might also be useful in treating advanced heart failure. In contrast, partial left ventriculectomy is not recommended.

show abstract

Ventricular Reconstruction Results in Improved Left Ventricular Function and Amelioration of Mitral Insufficiency

Cited by 36 publications

References 15 publications

Ischemic Mitral Regurgitation on the Threshold of a Solution

Ischemic Mitral Regurgitation on the Threshold of a Solution

Beneficial effects of endoventricular circular patch plasty in patients with left ventricular systolic dysfunction and left ventricular dyskinetic or akinetic apical segment

Surgical Treatment of Advanced Heart Failure

Contact Info

Product

Resources

About