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Related Experiment Videos

Endoventricular patch reconstruction in large ischemic wall-motion abnormalities.

V Dor1, M Sabatier, F Montiglio

  • 1The Centre Cardio-Thoracique, Monaco. vdor@ccm.mc

Journal of Cardiac Surgery
|March 18, 2000
PubMed
Summary
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Endoventricular patch plasty (EVPP) rebuilds the left ventricle for advanced ischemic heart disease. This surgical repair offers an alternative to cardiac transplant, improving outcomes in 80% of patients.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Repair Techniques
  • Ischemic Heart Disease Management

Background:

  • Endoventricular patch plasty (EVPP) has been utilized since 1984 for left ventricular reconstruction.
  • The authors' group has extensive experience with over 835 EVPP cases.
  • Large wall-motion abnormalities, defined as >60% left ventricular circumference asynergy, were a focus.

Purpose of the Study:

  • To analyze the global results of EVPP on the last 700 operated patients.
  • To evaluate the efficacy of EVPP in patients with advanced ischemic heart disease and severely impaired ejection fraction.
  • To present EVPP as a viable alternative to cardiac transplantation.

Main Methods:

  • Surgery was performed on the arrested heart.

Related Experiment Videos

  • A patch was inserted within the left ventricle to rebuild the contractile area.
  • Targeted residual volume was maintained between 50-70 cc/m2 of body surface area.
  • Analysis included three series of patients with large wall-motion abnormalities, with 269 patients having ejection fraction <30%.

    • Main Results:

    • The study analyzed results from the last 700 EVPP procedures.
    • Significant improvement was observed in approximately 80% of patients.
    • The operative risk associated with the EVPP procedure was approximately 12%.

    Conclusions:

    • Endoventricular patch plasty (EVPP) is an appropriate surgical option for advanced stages of ischemic heart disease.
    • EVPP serves as a valuable alternative to cardiac transplantation for select patients.
    • The technique demonstrates a favorable outcome profile with acceptable operative risk.