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Surgical ventricular restoration combined with mitral valve procedure for endstage ischemic cardiomyopathy

Hisayoshi Suma1, Hiroaki Tanabe, Tokuhisa Uejima

  • 1The Cardiovascular Institute, 7-3-10 Roppongi, Minato-ku, Tokyo 106-0032, Japan. sumah@cvi.or.jp

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|April 28, 2009
PubMed

Insights

Combined mitral and left ventricular reconstruction effectively treats advanced ischemic heart failure with dilated left ventricles and mitral regurgitation, improving survival and heart function.

Area of Science:

  • Cardiovascular Surgery
  • Heart Failure Management
  • Cardiac Reconstruction

Background:

  • Dilated left ventricle with mitral regurgitation signifies severe chronic ischemic heart failure.
  • Optimal surgical strategies for these complex cases remain a focus of research.

Purpose of the Study:

  • To evaluate the 7-year experience with combined mitral valve and left ventricular reconstruction.
  • To assess the efficacy and outcomes of this combined approach in advanced heart failure patients.

Main Methods:

  • Retrospective analysis of 76 patients with advanced heart failure due to dilated ischemic cardiomyopathy and mitral regurgitation.
  • Procedures included mitral reconstruction (repair or replacement) and left ventriculoplasty (Dor, SAVE, PLV) combined with coronary artery bypass grafting (CABG).

Main Results:

  • Operative mortality was 7.9%, with lower rates in elective cases.
  • Significant improvements observed in ejection fraction (24.9% to 33.3%) and cardiac index (2.0 to 2.6 L/min/m²).
  • Reduced ventricular volumes and improved NYHA class (3.5 to 1.4) in survivors; 5-year survival rate was 67.7%.

Conclusions:

  • Combined mitral and left ventricular reconstruction is an effective treatment for end-stage ischemic cardiomyopathy.
  • The procedure significantly improves cardiac function and clinical status in patients with dilated left ventricle and mitral regurgitation.
Abstract

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