Mid-term changes of left ventricular geometry and function after Dor, SAVE, and Overlapping procedures.

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• End-stage ischemic heart disease often necessitates left ventricular (LV) reconstruction.
• Surgical techniques like Dor, septal anterior ventricular exclusion (SAVE), and Overlapping aim to remodel the LV.
• Mid-term changes in LV geometry and function following these procedures require thorough investigation.

Purpose of the Study:

• To investigate mid-term changes in left ventricular (LV) geometry and function after Dor, SAVE, and Overlapping ventricular remodeling procedures.
• To compare the efficacy of these different LV reconstruction techniques.

Main Methods:

• Forty-three patients with end-stage ischemic heart disease underwent LV reconstruction.
• Patients were divided into Dor (n=15), SAVE (n=12), and Overlapping (n=16) groups.
• Echocardiography assessed LV dimensions, volumes, ejection fraction, deceleration time, sphericity index, and mitral regurgitation preoperatively and postoperatively (immediate and mid-term).

Main Results:

• Dor group: Significant LV volume reduction initially, followed by increase; increased sphericity index.
• SAVE group: Significant reduction in deceleration time, with no later improvement.
• Overlapping group: Significant and persistent LV volume reduction; maintained elliptical shape without significant change in sphericity index.

Conclusions:

• Dor procedure associated with LV sphericity progression; SAVE procedure with persistent deceleration time reduction.
• Overlapping procedure demonstrated significant LV volume reduction and maintenance of elliptical shape.
• Overlapping procedure showed acceptable early and late mortality, suggesting it as a favorable option.