Early Results of Left Ventricular Reconstruction for Ischemic Cardiomyopathy with Severe Left Ventricular Dysfunction

(Department of Cardiovascular Surgery, Kochi Health Sciences Center, Kochi, Japan)

Satofumi Tanaka Manabu Okabe Jin Tanaka
Yoichiro Miyake Iwao Hioki Takemi Handa
Left ventricular reconstruction methods (LVR) consisting of the Dor procedure or septal anterior ventricular exclusion (SAVE) have been advocated for left ventricular dysfunction due to ischemic cardiomyopathy (ICM). This study reports early results achieved with LVR in patients with ICM. Between April 2001 and August 2004, 9 patients with ICM underwent LVR and coronary artery bypass grafting (CABG). Their age was 62}11 years, and 7 were men. The Dor procedure was performed in 8 patients and 1 patient underwent SAVE. CABG was performed in all patients. Two patients with grade 3 mitral regurgitation (MR) preoperatively had mitral valve annuloplasty (MAP). The mean left ventricular ejection fraction (LVEF) improved from 31.6}7.2% to 47.8}9.4%. The mean left ventricular end diastolic volume index (LVEDVI) decreased from 166.7}50.4ml/m2 to 102.6}23.0ml/m2. The mean left ventricular end systolic volume index (LVESVI) decreased from 114.4}34.7ml/m2 to 52.4}16.6ml/m2. The mean coaptation depth decreased from 9.3}3.1mm to 4.5}1.4mm. The mean MR, with or without MAP, improved from grade 1.7}1.1 to grade 0.2}0.4. There were no hospital deaths. Seven of 9 patients were categorized as New York Heart Association functional class I at discharge. We conclude that LVR is an effective treatment for ICM with severe left ventricular dysfunction.
@Jpn. J. Cardiovasc. Surg. 35: 193-197 (2006)