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Echocardiographic findings using tissue velocity imaging following passive containment surgery with the Acorn CorCap
Arne Olsson1, Fredrik Bredin, Anders Franco-Cereceda
1Departments of Clinical Physiology and Thorax, Section of Cardiothoracic Surgery, Karolinska University Hospital, S-171 76 Stockholm, Sweden.
Insights
The CorCap Cardiac Support Device improved heart failure patients' functional status and reduced left ventricular size in dilated cardiomyopathy. However, it did not improve cardiac output and was associated with decreased right ventricular function.
Area of Science:
- Cardiology
- Cardiac Surgery
- Heart Failure Management
Background:
- Dilated cardiomyopathy (DCM) is a leading cause of heart failure.
- Conventional treatments for DCM have limitations.
- Passive containment surgery with the CorCap device offers a novel therapeutic approach.
Purpose of the Study:
- To echocardiographically assess the impact of the CorCap Cardiac Support Device on cardiac function and dimensions.
- To evaluate the efficacy of passive containment surgery in patients with dilated cardiomyopathy.
Main Methods:
- A prospective study involving 12 patients with dilated cardiomyopathy undergoing cardiac surgery.
- Patients received the CorCap device, with some undergoing concomitant procedures like coronary artery bypass grafting or mitral valve annuloplasty.
- Echocardiographic parameters and functional status (6-min walk, NYHA class) were assessed post-surgery.
Main Results:
- Significant improvements in cardiac dimensions, including decreased left ventricular end-diastolic and end-systolic diameters.
- Enhanced functional status, evidenced by increased 6-min walk distance and improved NYHA class.
- A notable decrease in right ventricular function (tricuspid annular velocities) was observed, while left ventricular function and output remained unchanged.
Conclusions:
- The CorCap device, when added to conventional cardiac surgery, improves clinical status and reduces left ventricular size in DCM patients.
- The observed benefits on left ventricular dimensions were not associated with improved cardiac output.
- The study identified a concurrent decline in right ventricular function, the clinical significance of which requires further investigation.
Objective:
To echocardiographically evaluate the effects of passive containment surgery using the CorCap Cardiac Support Device in heart failure patients with dilated cardiomyopathy.
Methods:
Twelve patients with dilated cardiomyopathy subjected to cardiac surgery received the Cardiac Support Device. Patients with ischemic cardiomyopathy (n=5) underwent coronary artery bypass surgery receiving 1-3 bypass grafts. In the idiopathic cardiomyopathy group (n=7), mitral valve annuloplasty was performed in five patients while two patients received the Cardiac Support Device only.
Results:
Following surgery there was a gradual, sustained improvement in cardiac dimensions (decreased left ventricular end-diastolic diameter and left ventricular end-systolic diameter) combined with an increase in functional status (6-min walk and NYHA class). Concomitantly there was a marked decrease in right ventricular function (decrease in tricuspid annular systolic and diastolic velocities) while the left ventricular function (mitral annular systolic and diastolic velocities) and output (ejection fraction, stroke volume) remained unchanged.
Conclusions:
Addition of the Cardiac Support Device to conventional cardiac surgery improves patient status and decreases left ventricular size in heart failure patients with dilated cardiomyopathy. The positive effect on left ventricular dimensions is not accompanied by any improvement in cardiac output but rather right ventricular dysfunction, although the functional significance of this is unclear.
