Reverse remodeling after endoventricular circular patch plasty in the mid-term period

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Anterior left ventricular (LV) aneurysms can impair myocardial function.
• Surgical repair aims to restore cardiac structure and function.
• Previous reports suggest improved function in the inferior LV wall post-anterior LV aneurysm repair.

Purpose of the Study:

• To evaluate mid-term changes in regional wall motion within the right coronary artery (RCA) territory after endoventricular circular patch plasty (EVCPP).
• To assess the impact of concomitant coronary artery bypass grafting (CABG) to the RCA on myocardial function post-EVCPP.

Main Methods:

• Quantitative Gated Single-Photon Emission Computed Tomography (QGS) was used to assess wall motion.
• Eighteen patients undergoing EVCPP were studied preoperatively and at early and mid-term follow-up.
• Regional wall thickening was measured, comparing patients with (Group B) and without (Group N) CABG to the RCA.

Main Results:

• Significant improvement in regional wall thickness was observed in the RCA territory by the mid-term follow-up in both groups.
• Despite worse preoperative wall thickness, Group B showed comparable mid-term functional improvement to Group N.
• Inferior LV wall motion improved irrespective of whether CABG to the RCA was performed.

Conclusions:

• Endoventricular circular patch plasty (EVCPP) promotes reverse remodeling and improves myocardial function in the inferior LV wall.
• The benefits of EVCPP on LV wall motion are evident in the mid-term, even in patients with significant RCA lesions.