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Cell-based Therapy for Heart Failure in Rat: Double Thoracotomy for Myocardial Infarction and Epicardial Implantation of Cells and Biomatrix
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Cell-based Therapy for Heart Failure in Rat: Double Thoracotomy for Myocardial Infarction and Epicardial Implantation of Cells and Biomatrix

Published on: September 22, 2014

[Surgical treatment of failures or recurrences after Heller cardiomyotomy (author's transl)]

F Fekete, P Breil

    Acta Chirurgica Belgica
    |July 1, 1982
    PubMed

    Insights

    Heller cardiomyotomy for achalasia offers a 96% success rate, with surgery preferred over dilation. Addressing complications like reflux and insufficient myotomy through appropriate re-intervention is crucial for optimal patient outcomes.

    Area of Science:

    • Gastroenterology
    • Surgical Procedures

    Context:

    • Achalasia is a primary esophageal motility disorder.
    • Heller cardiomyotomy is a common surgical intervention for achalasia.

    Purpose:

    • To evaluate the outcomes and identify failure patterns of Heller cardiomyotomy in achalasia patients.
    • To define indications for surgery and management strategies for complications.

    Summary:

    • A retrospective analysis of 406 Heller cardiomyotomies for achalasia revealed a 96% favorable outcome rate.
    • Surgical intervention is recommended over pneumatic dilation.
    • Common failures included insufficient myotomy (requiring re-myotomy) and gastro-esophageal reflux (often necessitating esophagogastric resection).
    • Accurate preoperative assessment is vital to avoid treatment errors for atypical presentations.
    • Postoperative complications like asystolia and the risk of cancer underscore the importance of early, correctly performed abdominal myotomy.

    Impact:

    • Heller cardiomyotomy is a highly effective treatment for achalasia when indications are clear and the procedure is performed correctly.
    • Understanding failure mechanisms guides re-intervention strategies and emphasizes the importance of anti-reflux measures.
    • Early surgical intervention may reduce long-term risks, including malignancy.

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