PMID- 11766833
OWN - NLM
STAT- MEDLINE
DCOM- 20020313
LR  - 20190921
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 16
IP  - 2
DP  - 2001 Mar-Apr
TI  - Partial left ventriculectomy for patients with ischemic cardiomyopathy.
PG  - 145-52
AB  - BACKGROUND: Partial left ventriculectomy (PLV) has been performed in patients 
      with dilated cardiomyopathy (DCM), but improved myocardial energetics may make 
      PLV useful also for ischemic cardiomyopathy (ICM) unamenable to conventional 
      treatment. METHODS: Of 262 patients undergoing PLV, 94 patients with ICM as the 
      underlying pathology were analyzed and compared with 168 patients with DCM. 
      RESULTS: ICM patients were older (57.3 years vs 50.9 years, p = 0.0001) and 
      heavier (69.7 kg vs 65.9 kg, p = 0.039) than those with DCM, but ventricular 
      end-diastolic and end-systolic dimensions were similar with comparably depressed 
      fractional shortening (16% vs 15%, p = 0.294) and equally severe functional 
      limitation [New York Heart Association (NYHA) Class 3.7 vs 3.6, p = 0.734]. A 
      majority of patients in both groups underwent lateral PLV (76% vs 74%, p = 0.883) 
      with myocardium excised between papillary muscles and simultaneous mitral 
      valvuloplasty (41% vs 74%, p < 0.0001). Because ICM patients required coronary 
      artery bypass grafting (CABG) more frequently (79% vs 0.6%, p < 0.0001), 
      operation was more extensive in terms of bypass time (74 minutes vs 47 minutes, p 
      < 0.0001), percentage requiring cardiac arrest (43% vs 19%, p < 0.0001), and 
      arrest duration (34 minutes vs 28 minutes, p = 0.280), but all had similar 
      resection and postoperative ventricular dimensions. Nonetheless, ICM patients 
      required shorter intensive care unit (ICU) time (4.4 days vs 5.9 days, p = 0.048) 
      and similar postoperative hospital stays, resulting in similar hospital survival 
      rates (69% vs 71%, p = 0.778) and functional capacity in long-term follow-up. 
      CONCLUSIONS: Results suggest that PLV can be performed in patients with ICM with 
      comparable risks and benefits as in DCM. Relative efficacy of CABG and mitral 
      repair as compared to volume reduction remains to be studied.
FAU - Fujimura, T
AU  - Fujimura T
AD  - Department of Cardiovascular Surgery and Transplantation, Tokai University, 
      Bohseidai, Isehara, Japan.
FAU - Kawaguchi, A T
AU  - Kawaguchi AT
FAU - Ishibashi-Ueda, H
AU  - Ishibashi-Ueda H
FAU - Bergsland, J
AU  - Bergsland J
FAU - Koide, S
AU  - Koide S
FAU - Batista, R J
AU  - Batista RJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Cardiac Surgical Procedures/*methods
MH  - Cardiomyopathy, Dilated/etiology/*surgery
MH  - Female
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/*complications
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2002/01/05 10:00
MHDA- 2002/03/14 10:01
CRDT- 2002/01/05 10:00
PHST- 2002/01/05 10:00 [pubmed]
PHST- 2002/03/14 10:01 [medline]
PHST- 2002/01/05 10:00 [entrez]
AID - 10.1111/j.1540-8191.2001.tb00500.x [doi]
PST - ppublish
SO  - J Card Surg. 2001 Mar-Apr;16(2):145-52. doi: 10.1111/j.1540-8191.2001.tb00500.x.