PMID- 11343953
OWN - NLM
STAT- MEDLINE
DCOM- 20010823
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 19
IP  - 5
DP  - 2001 May
TI  - Left ventricle restoration in patients with non-ischemic dilated cardiomyopathy: 
      risk factors and predictors of outcome and change of mid-term ventricular 
      function.
PG  - 684-9
AB  - OBJECTIVE: The partial left ventriculectomy (PLV) for end-stage dilated 
      cardiomyopathy (DCM) which worked in some patients has been reported, although 
      the hospital mortality is high. To reduce hospital mortality, we selected 
      operative procedures of left ventricular (LV) restoration to improve the 
      operative results. We analyzed the risk factors and predictors of outcome, and 
      the mid-term changes of the LV function were determined. PATIENTS AND METHODS: 
      Between December 1996 and September 2000, 74 patients with non-ischemic DCM 
      received LV restoration. The age ranged from 14 to 76 years (mean, 49.0+/-14.0 
      years), and there were 63 men and 11 women. The etiology of the DCM was 
      idiopathic DCM in 49 patients, and dilated hypertrophic cardiomyopathy in seven 
      patients and others in 18. The preoperative New York Heart Association (NYHA) 
      functional class was 29 in class III and 45 in class IV, in which 32 patients 
      depended on inotropic support. PLV or septal anterior ventricular exclusion 
      (SAVE) was selected depending on the akinetic lesion of the LV based on the 
      intraoperative echo-test. Fifty-six patients received elective operations, and 
      emergency operations were performed in 18 patients. The risk factors and 
      predictors of outcome were analyzed in 74 patients, and in 35 patients who 
      survived more than 1 year after receiving LV restoration, the mid-term cardiac 
      function was examined by cardiac echogram and catheterization. RESULTS: PLV was 
      performed in 62 patients and SAVE in 12 patients. Concomitant mitral surgery was 
      performed in 66 patients (89%) and tricuspid annuloplasty in 42 patients (57%). 
      There were 15 hospital deaths and 13 patients died after discharge from the 
      hospital (cardiac deaths in nine and non-cardiac deaths in four). In the 46 late 
      survivors, the NYHA class was I or II in 42 patients and III in four patients. 
      Selection of the procedure of LV restoration (P<0.01), elective operation 
      (P<0.05), and the preoperative volume of LV (endodiastolic volume index of <180 
      ml/m(2); P<0.05) were risk factors and predictors influencing hospital and late 
      death. After the operation, the LV function improved significantly and the 
      improvement was maintained at the mid-term period; the LV ejection fraction was 
      31.8+/-7.9% (P<0.01) at 1 year from 23.0+/-7.3% preoperatively, left ventricular 
      diastolic diameter was 62.8+/-10.9 (P<0.01) from 81.7+/-8.2 mm and the LV 
      endosystolic volume index was 88.5+/-45.8 (P<0.05) from 162.6+/-41.6 ml/m(2). 
      CONCLUSIONS: The operative results improved with the selection of the procedures, 
      with elective operation, and mitral plasty for less cardiac dilatation. The 
      mid-term results of clinical status and LV function showed the effectiveness of 
      the operation.
FAU - Isomura, T
AU  - Isomura T
AD  - Hayama Heart Center, 1898 Shimoyamaguchi, Hayama, 240-0116, Kanagawa, Japan. 
      mail@hayamaheart.gr.jp
FAU - Suma, H
AU  - Suma H
FAU - Horii, T
AU  - Horii T
FAU - Sato, T
AU  - Sato T
FAU - Kobashi, T
AU  - Kobashi T
FAU - Kanemitsu, H
AU  - Kanemitsu H
FAU - Hoshino, J
AU  - Hoshino J
FAU - Hisatomi, K
AU  - Hisatomi K
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cardiomyopathy, Dilated/physiopathology/*surgery
MH  - Cardiomyopathy, Hypertrophic/physiopathology/surgery
MH  - Female
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Intraoperative Period
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
EDAT- 2001/05/10 10:00
MHDA- 2001/08/24 10:01
CRDT- 2001/05/10 10:00
PHST- 2001/05/10 10:00 [pubmed]
PHST- 2001/08/24 10:01 [medline]
PHST- 2001/05/10 10:00 [entrez]
AID - S1010794001006716 [pii]
AID - 10.1016/s1010-7940(01)00671-6 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2001 May;19(5):684-9. doi: 
      10.1016/s1010-7940(01)00671-6.