PMID- 15464325
OWN - NLM
STAT- MEDLINE
DCOM- 20041027
LR  - 20220408
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 44
IP  - 7
DP  - 2004 Oct 6
TI  - Surgical ventricular restoration in the treatment of congestive heart failure due 
      to post-infarction ventricular dilation.
PG  - 1439-45
AB  - OBJECTIVES: The purpose of this study was to test how surgical ventricular 
      restoration (SVR) affects early and late survival in a registry of 1,198 
      post-anterior infarction congestive heart failure (CHF) patients treated by the 
      international Reconstructive Endoventricular Surgery returning Torsion Original 
      Radius Elliptical shape to the left ventricle (RESTORE)team. BACKGROUND: 
      Congestive heart failure may be caused by late left ventricular (LV) dilation 
      after anterior infarction. The infarcted segment is often akinetic rather than 
      dyskinetic because early reperfusion prevents transmural necrosis. Previously, 
      only dyskinetic areas were treated by operation. Surgical ventricular restoration 
      reduces LV volume and creates a more elliptical chamber by excluding scar in 
      either akinetic or dyskinetic segments. METHODS: The RESTORE group applied SVR to 
      1,198 post-infarction patients between 1998 and 2003. Early and late outcomes 
      were examined, and risk factors were identified. RESULTS: Concomitant procedures 
      included coronary artery bypass grafting in 95%, mitral valve repair in 22%, and 
      mitral valve replacement in 1%. Overall 30-day mortality after SVR was 5.3% (8.7% 
      with mitral repair vs. 4.0% without repair; p < 0.001). Perioperative mechanical 
      support was uncommon (<9%). Global systolic function improved postoperatively. 
      Ejection fraction (EF) increased from 29.6 +/- 11.0% preoperatively to 39.5 +/- 
      12.3% postoperatively (p < 0.001). The left ventricular end-systolic volume index 
      (LVESVI) decreased from 80.4 +/- 51.4 ml/m(2) preoperatively to 56.6 +/- 34.3 
      ml/m(2) postoperatively (p < 0.001). Overall five-year survival was 68.6 +/- 
      2.8%. Logistic regression analysis identified EF <or=30%, LVESVI >or=80 ml/m(2), 
      advanced New York Heart Association (NYHA) functional class, and age >or=75 years 
      as risk factors for death. Five-year freedom from hospital readmission for CHF 
      was 78%. Preoperatively, 67% of patients were NYHA functional class III or IV and 
      postoperatively, 85% were class I or II. CONCLUSIONS: Surgical ventricular 
      restoration improves ventricular function and is highly effective therapy in the 
      treatment of ischemic cardiomyopathy with excellent five-year outcome.
FAU - Athanasuleas, Constantine L
AU  - Athanasuleas CL
AD  - Norwood Clinic and Kemp Carraway Heart Institute, Birmingham, Alabama, USA.
FAU - Buckberg, Gerald D
AU  - Buckberg GD
FAU - Stanley, Alfred W H
AU  - Stanley AW
FAU - Siler, William
AU  - Siler W
FAU - Dor, Vincent
AU  - Dor V
FAU - Di Donato, Marisa
AU  - Di Donato M
FAU - Menicanti, Lorenzo
AU  - Menicanti L
FAU - Almeida de Oliveira, Sergio
AU  - Almeida de Oliveira S
FAU - Beyersdorf, Friedhelm
AU  - Beyersdorf F
FAU - Kron, Irving L
AU  - Kron IL
FAU - Suma, Hisayoshi
AU  - Suma H
FAU - Kouchoukos, Nicholas T
AU  - Kouchoukos NT
FAU - Moore, Wistar
AU  - Moore W
FAU - McCarthy, Patrick M
AU  - McCarthy PM
FAU - Oz, Mehmet C
AU  - Oz MC
FAU - Fontan, Francis
AU  - Fontan F
FAU - Scott, Meredith L
AU  - Scott ML
FAU - Accola, Kevin A
AU  - Accola KA
CN  - RESTORE group
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2005 Aug 2;46(3):562; author reply 562-3. PMID: 16053978
MH  - Aged
MH  - Blood Pressure
MH  - Coronary Artery Bypass
MH  - Dilatation, Pathologic/complications/etiology/surgery
MH  - Female
MH  - Heart Failure/etiology/pathology/*physiopathology/*surgery
MH  - Heart Valve Prosthesis
MH  - Heart Ventricles/*pathology/physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/surgery
MH  - Myocardial Infarction/*complications/pathology/physiopathology
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Treatment Outcome
EDAT- 2004/10/07 09:00
MHDA- 2004/10/28 09:00
CRDT- 2004/10/07 09:00
PHST- 2004/05/12 00:00 [received]
PHST- 2004/06/24 00:00 [revised]
PHST- 2004/07/06 00:00 [accepted]
PHST- 2004/10/07 09:00 [pubmed]
PHST- 2004/10/28 09:00 [medline]
PHST- 2004/10/07 09:00 [entrez]
AID - S0735-1097(04)01443-3 [pii]
AID - 10.1016/j.jacc.2004.07.017 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2004 Oct 6;44(7):1439-45. doi: 10.1016/j.jacc.2004.07.017.