[Dor operation for end-stage ischemic cardiomyopathy]

Area of Science:

• Cardiovascular Surgery
• Cardiology
• Cardiac Surgery

Context:

• End-stage dilated ischemic cardiomyopathy presents significant challenges in treatment.
• Patients often have reduced ejection fraction and severe heart failure symptoms.
• The Dor operation offers a potential surgical solution for these complex cases.

Purpose:

• To evaluate the efficacy of the endoventricular circular patch plasty (Dor operation) in treating end-stage dilated ischemic cardiomyopathy.
• To assess the perioperative and long-term outcomes of the Dor procedure combined with other cardiac surgeries.

Summary:

• The Dor procedure was performed on 13 patients with end-stage ischemic cardiomyopathy, often combined with coronary artery bypass grafting and mitral valve surgery.
• No perioperative deaths occurred, and while three in-hospital deaths were reported, survivors showed significant improvements.
• Ejection fraction increased from 22% to 36%, with reduced ventricular volumes and pulmonary capillary wedge pressure post-surgery.

Impact:

• The Dor operation demonstrates effectiveness in improving cardiac function and New York Heart Association (NYHA) class in patients with severe ischemic cardiomyopathy.
• It serves as a viable surgical alternative for patients who might otherwise be candidates for heart transplantation.
• The procedure leads to significant functional recovery and reduced heart failure burden.