Angiographic assessment of surgical reconstructions for left ventricular asynergy with indices of abnormally contracting segments
Related Experiment Video
Updated: Oct 2, 2026
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
M Ikeda1, H Ohashi, Y Tsutsumi
1Department of Cardiovascular Surgery, Toyama Japan Red Cross Hospital, Ushijimahon-machi 2-1-58, Toyama 930-0859, Japan.
Background:
In surgical reconstruction for left ventricular asynergy after myocardial infarction, the conventional linear closure technique second to simple resection and endoventricular circular patch plasty, which is the so-called Dor technique, are commonly utilized. We assessed these techniques using an abnormally contracting segment (ACS) in the left ventriculogram.
Methods:
We reviewed 10 and 15 patients who underwent the linear technique (group L) and the Dor technique (group D), respectively. %ACS was determined as the percent ratio of both akinetic and dyskinetic chords among the total chords in the centerline method of regional wall motion analysis. A difference between preoperative and postoperative ejection fraction (EF) was generated by preoperative EF and this percentage ratio was determined as %EF.
Results:
Postoperative EF improved from 31% to 41% in group L and from 33% to 49% in group D (p<0.05). Postoperative EF in group D was higher than in group L (p<0.05). %ACS decreased from 41% to 34% in group L and from 41% to 19% in group D (p<0.05). Postoperative %ACS was lower in group D than in group L (p<0.05). The significant correlation between preoperative %ACS and %EF was negative in group L and positive in group D (p<0.05).
Conclusions:
The Dor technique is more effective for the postoperative systolic function than the linear technique because more extensive reduction in %ACS is possible with the Dor technique than with the linear technique. Dor technique becomes more crucial to the postoperative systolic function as the preoperative %ACS becomes larger.