Medium-term results of surgical ventricular restoration with papillary muscle realignment: providing additional benefits in enlarged ischemic left ventricle.
Surg Technol Int
; 17: 222-6, 2008.
Article
em En
| MEDLINE
| ID: mdl-18802906
ABSTRACT
In 2001, we described a new surgical technique of surgical ventricular restoration (SVR) in severe heart failure by papillary muscle re-alignment and volume reduction. This procedure has been offered in our institution to patients with severely impaired left ventricular function. Here we examine our mid-term results and also compare them with a similar cohort of patients who had coronary artery bypass grafting (CABG) only. Between 1998 and 2005, 30 patients underwent SVR by papillary muscle realignment with coronary artery revascularization at our institution. A subset of 20 patients had their left ventricular volume measured by echocardiogram and MRI scan, and a maximal cardiopulmonary exercise test was performed before and after the operation. An unselected consecutive cohort of patients with matching age, gender, and hemodynamic status who underwent CABG only without SVR was tested using the same protocol and the results were compared. We noticed that there was a significant advantage for patients who had additional SVR over patients who had CABG only. The observed improvement in those who had SVR may be due to reduced metabolic mismatch as a result of reduced wall tension and normalization of the apical twist of the left ventricle. We believe this would provide a form of surgical treatment for heart failure secondary to ischemic cardiomyopathy at a time of reduced donor organ availability for transplant.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Músculos Papilares
/
Ponte de Artéria Coronária
/
Hipertrofia Ventricular Esquerda
/
Disfunção Ventricular Esquerda
/
Insuficiência Cardíaca
/
Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Surg Technol Int
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Reino Unido