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Functional capacity late after partial left ventriculectomy: relation to ventricular geometry and performance.
Z Popović1, M Mirić, A N Nesković
1Dr. Aleksandar D. Popovic Cardiovascular Research Center, Dedinje Cardiovascular Institute, Milana Tepica 1, 11040, Belgrade, Yugoslavia. sconic@eunet.yu
Summary
Late survivors of partial left ventriculectomy (PLV) for dilated cardiomyopathy (DCM) with better functional status maintained favorable left ventricular (LV) geometry. Poor outcomes were linked to altered LV shape after surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Imaging
Background:
- Partial left ventriculectomy (PLV) is a surgical option for non-ischemic dilated cardiomyopathy (DCM).
- The long-term functional benefits and determinants of success after PLV are not well understood.
- Assessing left ventricular (LV) geometry and function is crucial for understanding patient outcomes.
Purpose of the Study:
- To investigate the relationship between LV shape, function, and functional status in long-term survivors of PLV for DCM.
- To identify predictors of sustained functional improvement after PLV.
Main Methods:
- A cohort of 17 patients with non-ischemic DCM who underwent PLV and survived over 12 months were studied.
- Invasive hemodynamic assessments were performed pre-operatively, early, mid-term, and late post-operatively.
- Patients were categorized into responders and non-responders based on functional status at late follow-up.
Main Results:
- Responders exhibited a higher LV systolic major-to-minor axis ratio at all follow-up points.
- LV ejection fraction was lower in non-responders at late follow-up.
- While LV circumferential end-diastolic stress initially decreased, it increased in non-responders over time.
Conclusions:
- Postoperative LV geometry significantly influences functional capacity in late survivors of PLV for DCM.
- Maintaining favorable LV shape post-PLV may be key to sustained functional improvement.