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[Overlapping ventriculoplasty for ischemic cardiomyopathy].
Kimihiro Yoshimoto1, Y Matsui, Y Fukada
1Department of Cardiovascular Surgery, NTT East Corporation Sapporo Hospital, Sapporo, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|April 15, 2005
Summary
Integrated overlapping ventriculoplasty (IOLVP) effectively treats ischemic cardiomyopathy with a dilated left ventricle. This surgical technique improves heart function and shape, offering a promising option for patients.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Heart Failure Management
Background:
- Dilated cardiomyopathy previously treated with overlapping cardiac volume reduction operation (OLCVR).
- Extension of OLCVR to ischemic cardiomyopathy (ICM) with dilated left ventricle (LV) due to positive outcomes.
- Excellent ellipsoidal LV shape achieved with OLCVR.
Purpose of the Study:
- To evaluate the efficacy of integrated overlapping ventriculoplasty (IOLVP) in patients with ICM and dilated LV.
- To assess the combined procedure of OLCVR, mitral annuloplasty, and papillary muscle approximation (PMA) for ICM.
- To analyze pre- and postoperative hemodynamic and functional outcomes.
Main Methods:
- IOLVP combined with mitral annuloplasty and papillary muscle approximation (PMA) performed on 8 ICM patients.
- Coronary artery bypass grafting (CABG) was performed concurrently.
- Pre- and postoperative data collection included LV ejection fraction (LVEF), LV end-diastolic volume index (LVEDVI), LV end-diastolic diameter (LVDd), mitral regurgitation, and NYHA functional class.
Main Results:
- No operative mortality observed in the 8 patients.
- Significant improvement in LVEF from 22.4% to 33.4%.
- Significant reduction in LVEDVI from 155.5 to 93.7 ml/m2 and LVDd from 66.0 to 60.5 mm.
- Mitral regurgitation improved from 2.6 to 0.1 degree.
- NYHA functional class improved from 3.3 to 1.3.
- Achieved ellipsoidal LV shape without akinesis.
Conclusions:
- IOLVP is a safe and effective surgical option for ICM with a dilated left ventricle.
- The procedure significantly improves cardiac function, reduces ventricular volume, and corrects mitral regurgitation.
- IOLVP restores a more physiological LV shape, contributing to improved clinical outcomes.