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Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
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Efficacy of left ventricular restoration with mitral valve surgery for endstage ischemic cardiomyopathy

Fumikazu Nomura1, Tadashi Isomura, Taiko Horii

  • 1Cardiovascular Surgery, Hayama Heart Center, 1898 Shimoyamaguchi Hayama, Kanagawa, 240-0116, Japan. nomura@hayamaheart.gr.jp

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

Left ventricular restoration (LVR) surgery combined with mitral valve repair significantly reduces heart size and improves patient function in ischemic cardiomyopathy (ICM). This aggressive treatment offers a 71.2% 5-year survival rate for end-stage ICM patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Heart Failure Research

Background:

  • Ischemic cardiomyopathy (ICM) presents a high risk of mortality and ischemic events.
  • Effective treatment strategies for end-stage ICM remain critical.

Purpose of the Study:

  • To assess the impact of left ventricular restoration (LVR) and mitral valve surgery on cardiac function and clinical status in ICM patients.
  • To evaluate the efficacy of an aggressive surgical approach for end-stage ICM.

Main Methods:

  • Study included 26 patients (mean age 64) with severe left ventricular dilation (LVESVI ≥ 100 ml/m2).
  • Procedures performed: Coronary artery bypass grafting, mitral valve surgery, and LVR.
  • Evaluated changes in left ventricular volumes, ejection fraction, mitral regurgitation (MR), and NYHA functional class.

Main Results:

  • Significant reduction in left ventricular end-diastolic volume index (169 to 130 ml/m2) and LVESVI (120 to 89 ml/m2).
  • Marked improvement in mitral regurgitation (MR grade 2.7 to 1.0) and NYHA functional class (3.2 to 1.5).
  • Left ventricular ejection fraction remained unchanged; 5-year survival rate was 71.2%.

Conclusions:

  • Combined LVR and mitral valve surgery effectively reduces left ventricular volume in end-stage ICM.
  • This aggressive surgical strategy improves clinical functional status and offers significant survival benefits.
  • The approach addresses ischemia, reduces LV wall tension, and corrects mitral regurgitation.

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