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Left ventriculoplasty for nonischemic dilated cardiomyopathy
Taiko Horii1, Tadashi Isomura, Masashi Komeda
1Hasama Heart Center, Hayama, Kanagawa, Japan. horii@hayamaheart.gr.jp
Journal of Cardiac Surgery
|May 22, 2003
Summary
Left ventriculoplasty (LVP) effectively treats severe nonischemic dilated cardiomyopathy (DCM). Intraoperative echocardiography guides surgical choices, improving outcomes and survival rates in heart failure patients.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Technology
Background:
- Nonischemic dilated cardiomyopathy (DCM) causes severe heart failure.
- Medically refractory heart failure necessitates advanced treatment options.
Purpose of the Study:
- To evaluate the efficacy of left ventriculoplasty (LVP) for nonischemic DCM.
- To assess the impact of intraoperative echocardiography on LVP outcomes.
Main Methods:
- 82 patients with nonischemic DCM underwent LVP (partial left ventriculectomy or septal anterior ventricular exclusion).
- Intraoperative echocardiography guided surgical technique selection.
- Perioperative support included inotropic infusion, IABP, and LVAD in select cases.
Main Results:
- Overall hospital mortality was 20.7% (elective 8.2%, emergency 57.1%).
- One-year survival was 64.7% (elective 75.5%, emergency 37.9%).
- LVP improved LV ejection fraction and reduced LV dimensions and diastolic pressure, with sustained benefits up to two years.
Conclusions:
- Careful surgical selection guided by intraoperative echocardiography is crucial for effective LVP in nonischemic DCM.
- LVP can significantly improve cardiac function and functional class in patients with severe heart failure.