Ventricular Reconstruction Surgery for Congestive Heart Failure

Lee, Richard; Hoercher, Katherine J.; McCarthy, Patrick M.

doi:10.1159/000075986

Cited by 11 publications

(5 citation statements)

References 49 publications

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“…Registry data confirms collaborative information from the RESTORE multicenter cohort [2], and Dor [3] who launched this surgical evolution. Furthermore, these functional and mortality late findings are unachievable by CABG with or without mitral valve procedures [4][5][6].…”

Section: Editorial Commentsupporting

confidence: 66%

“…Thrombus was removed, infarcted nonviable tissue was resected, and the scar was excluded, generally by the use of a double cerclage circular closure [2]. Pericardial or Dacron patches were used as required, generally for those patients with a calcified aneurysm in whom the purse string sutures may not create a neck, or in patients with a small left ventricular cavity, to avoid creating too small a cavity [3]. A sizing balloon device was not used.…”

Section: Surgical Techniquementioning

confidence: 99%

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The impact of left ventricular reconstruction on survival in patients with ischemic cardiomyopathy

O’Neill

Starling

McCarthy

et al. 2006

European Journal of Cardio-Thoracic Surgery

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Section: Editorial Commentsupporting

confidence: 66%

Section: Surgical Techniquementioning

confidence: 99%

The impact of left ventricular reconstruction on survival in patients with ischemic cardiomyopathy

O’Neill

Starling

McCarthy

et al. 2006

European Journal of Cardio-Thoracic Surgery

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“…However, the in-hospital mortality was 5.5% bearing in mind that the Logistical EuroSCORE was 13.8% for the cohort. The in-hospital mortality in other series varies from 2.8 to 13%, influenced by the case selection, operative techniques, and experience at different units [4,21,22]. The five-year survival is similar compared to other published data at 84.7% with slightly better 10-year outcomes at 79.1%.…”

Section: Discussionmentioning

confidence: 51%

Impact of Surgical Ventricular Restoration on Cardiac Function, Ischaemic Mitral Regurgitation and Long-term Survival

Flemming¹

2015

J Cardiovasc Dis Diagn

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Objectives: Adverse cardiac remodelling is a major cause of morbidity and mortality post myocardial infarction. The role of surgical ventricular restoration compared to medical and electrophysiological treatments has recently come under intense scrutiny. We aimed to evaluate 10-year clinical outcomes of surgical ventricular restoration in our institution. Methods:From January 2001 to 2011, surgical ventricular restoration was performed in 126 consecutive patients (M2.3: 1F), mean age 65.5 (44-86) years. All patients presented with angina, heart failure and/or ventricular tachycardia. Post-infarction left ventricular aneurysm was present in all patients and ischemic dilated cardiomyopathy with a large akinetic left ventricle in 11.6%. The preoperative left ventricular ejection fraction was 33.1 ± 8.9%. Multi-vessel disease was present in 117/126(93%) patients. Mitral regurgitation more than grade+2 was found in 39/126(31%). The mean Logistic EuroSCORE was 13.8 ± 5.9%. A minimum of two-year post-operative follow-up was obtained on all patients.Results: Most patients underwent endoventricular or elliptical patch repair; 94% had concomitant coronary revascularisation with a median of 2 grafts and 5% had mitral valve repair. Intra-aortic balloon pump was placed preoperatively in 24/126 (19%) patients while 21/126 (17%) needed inotropic support for more than 24 h. Postoperative stroke occurred in 2 patients. In-hospital mortality was 7/126 (5.5%). All cause cardiovascular mortality at ten years was 12/126 (9.5%). Mean follow-up in operative survivors was 8.2 ± 1.2 years. Actuarial survival was 95.3%, 90.6%, 86.3% and 79.1% at 1-month, 1, 5 and 10-years. Echocardiographic follow-up demonstrated a reduction in the mean left ventricular end-diastolic volume and left atrial diameter. Ejection fraction improved over first year from 33.1 ± 8.9 to 45 ± 8.6% (P<0.006). Conclusions:Left ventricular reconstruction surgery is a good surgical option for treatment of post-infarction left ventricular aneurysm.

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“…The 30-day mortality was signifi cantly higher after MR surgery but there was no signifi cant difference in the survival rates between the two groups during the 5-year period, and MR was not found to be an independent predictor of late mortality. Lee et al (22) supported the opinion that MR degree was not associated with long-term survival after SVR. Menicanti et al (23) suggested that SVR, performed with or without CABG and with or without MV surgery, signifi cantly reduced LV volumes and improved LV EF; however, a signifi cant increase in LV volumes and MR degree was observed afterward.…”

Section: Discussionmentioning

confidence: 92%

The Impact of Surgical Ventricular Restoration on Ischemic Mitral Regurgitation

Butkuvienė

Ivaškevičienė

2011

Medicina

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Objective. The aim of current study was to evaluate and compare the changes in clinical status and mitral regurgitation (MR) grade and long-term postoperative survival after left ventricle surgical restoration (SVR) operations. Material and Methods. We retrospectively analyzed the data of 139 patients suffering from ischemic heart disease and left ventricular aneurysms or large akinesia, who underwent SVR and coronary artery bypass grafting without MR surgical correction between 1999 and 2006. The mean long-term postoperative follow-up was 3.6 years (SD, 3.0). Nine patients (6.5%) died during the first 30 postoperative days. Results. The mean MR grade during the long-term period increased significantly. The univariate logistic regression analysis showed that factors for the long-term mortality were age (P=0.002), decompensation signs before SVR (P=0.03), treatment with diuretics (P=0.01), NYHA functional class IV (P=0.008), and moderate and severe MR (P=0.04); however, multivariate logistic regression analysis demonstrated that only patient’s age was an independent predictive factor (P=0.004). MR correction was found to be a significant prognostic factor of borderline significance for perioperative mortality (P=0.05). The analysis of MR grade (mild versus moderate versus severe) impact on long-term survival failed to demonstrate any association (P=0.22). Conclusions. Remodeling continued during the long-term period after SVR and CABG: there was an increase in the mean MR degree. Left ventricular remodeling with moderate and severe MR decreased survival rates during long-term period after surgical ventricular restoration; however, mitral regurgitation was not found to be an independent predictor of poor outcome.

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Ventricular Reconstruction Surgery for Congestive Heart Failure

Cited by 11 publications

References 49 publications

The impact of left ventricular reconstruction on survival in patients with ischemic cardiomyopathy

The impact of left ventricular reconstruction on survival in patients with ischemic cardiomyopathy

Impact of Surgical Ventricular Restoration on Cardiac Function, Ischaemic Mitral Regurgitation and Long-term Survival

The Impact of Surgical Ventricular Restoration on Ischemic Mitral Regurgitation

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