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[Immediate results of reconstructive surgery in end-stage dilated cardiomyopathy]
Insights
Multistage surgical reconstruction offers improved outcomes for end-stage dilated cardiomyopathy patients ineligible for heart transplants. Procedures like Batista and Dor operations enhanced heart function and reduced heart size in most patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiomyopathy Research
Context:
- End-stage dilated cardiomyopathy presents significant challenges, often leading to heart transplantation candidacy.
- Patients with severely impaired hemodynamics and reduced ejection fraction require advanced treatment options.
Purpose:
- To summarize the initial experiences and outcomes of multistage surgical reconstruction for end-stage dilated cardiomyopathy.
- To evaluate the safety and efficacy of combined surgical techniques in complex cardiac cases.
Summary:
- Twenty-one patients with idiopathic or ischemic cardiomyopathy underwent multistage reconstruction, including Batista and Dor procedures, valve repair, and myocardial revascularization.
- Postoperative improvements included reduced heart size and a 10-12% increase in ejection fraction.
- Mortality occurred in four patients due to arrhythmia and heart failure; however, the majority showed significant clinical improvement.
Impact:
- Multistage surgical reconstruction demonstrates feasibility and potential benefits for patients with end-stage dilated cardiomyopathy.
- These complex procedures offer an alternative for patients not suitable for heart transplantation.
- The findings support the expediency of these reconstructive surgeries in select cardiac patients.
Abstract:
First experiences with multistage surgical reconstruction of the left ventricle, heart valves and coronary arteries in patients with the end stage dilated cardiomyopathy are summarized. During the last three years operations have been made on 21 patients aged from 24 to 63, eight patients having idiopathic cardiomyopathy and 13 ischemic cardiomyopathy. They had markedly disturbed hemodynamics, ejection fraction of the left ventricle less than 30% and its diastolic diameter more than 70 mm. Most of the patients were candidates for heart transplantation. The Batista and Dor operations were made in combination with plastic operations on the mitral and tricuspid valves. In patients with ischemic heart disease myocardial revascularization was also performed. Four patients died after operation from arrhythmia and heart failure, the others' state had improved with less sizes of the heart and 10-12% greater ejection fraction. A conclusion was made that such operations were expedient.