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[Dor's operation (endoventricular circular patch plasty)].

Tadashi Isomura1

  • 1Hayama Heart Center, Kanagawa, Japan.

Nihon Geka Gakkai Zasshi
|October 22, 2002
PubMed
Summary

Endoventricular circular patch plasty (EVCPP) improves cardiac function and prognosis in ischemic heart disease patients with akinesis or dyskinesis. This surgical repair enhances ejection fraction and reduces ventricular volume, offering a better outlook for patients.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Resynchronization Therapy
  • Ischemic Heart Disease Management

Context:

  • Ischemic heart disease frequently leads to left ventricular akinesis or dyskinesis, impairing cardiac function.
  • Traditional treatments may not fully address structural abnormalities caused by myocardial infarction.
  • Endoventricular circular patch plasty (EVCPP) offers a reconstructive approach for these specific ventricular dysfunctions.

Purpose:

  • To review the operative results of EVCPP (Dor's operation) for akinesis and dyskinesis in ischemic heart disease.
  • To evaluate the impact of EVCPP on cardiac function, ejection fraction (EF), and end-diastolic volume index (EDVI).
  • To assess the long-term prognosis and survival rates following EVCPP.

Summary:

  • EVCPP involves excluding akinetic/dyskinectic walls with a patch to restore left ventricular shape and function.
  • Studies report improved EF (e.g., 23% to 38%) and reduced EDVI (e.g., 248 to 107 ml/m2) post-EVCPP.
  • Author's experience shows improved EF (24% to 36%), reduced EDVI (153 to 103 ml/m2), and favorable NYHA class in 53/81 patients.

Impact:

  • EVCPP demonstrates effectiveness in improving postoperative cardiac function in patients with ischemic cardiomyopathy.
  • The procedure positively impacts patient prognosis, with comparable long-term survival rates to other patient groups.
  • EVCPP represents a valuable surgical option for selected patients with severe left ventricular wall motion abnormalities.

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