Radionuclide study of mid-term left ventricular function after endoventricular circular patch plasty.

Area of Science:

• Cardiovascular Surgery
• Cardiac Imaging
• Heart Failure Management

Background:

• Limited data exists on the long-term efficacy of endoventricular circular patch plasty (EVCPP).
• Assessing the sustained impact of EVCPP on left ventricular (LV) function is crucial for understanding its therapeutic value.

Purpose of the Study:

• To evaluate the early and mid-term changes in LV function following EVCPP using electrocardiographic-gated single-photon emission computed tomography (Gated SPECT).
• To determine if the functional improvements observed early after EVCPP are maintained over time.

Main Methods:

• Gated SPECT was performed on 14 patients (mean age 67 years) preoperatively, early post-EVCPP (23 days), and mid-term post-EVCPP (32 months).
• LV end-diastolic volume index (EDVI), LV end-systolic volume index (ESVI), and ejection fraction (EF) were quantified using the QGS(+) program.

Main Results:

• EVCPP significantly reduced EDVI and ESVI, and increased EF in the early postoperative period compared to preoperative values.
• ESVI continued to decrease, and EF continued to increase from the early to the mid-term follow-up.
• No significant changes in EDVI were observed between early and mid-term postoperative periods.

Conclusions:

• EVCPP directly and significantly improves LV function in the early postoperative phase.
• The observed improvements in ESVI and EF are sustained and further enhanced from the early to mid-term periods.
• These findings suggest that EVCPP promotes sustained reverse LV remodeling and offers long-lasting benefits.