PMID- 16567106
OWN - NLM
STAT- MEDLINE
DCOM- 20070110
LR  - 20191210
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 29 Suppl 1
DP  - 2006 Apr
TI  - A new concept of ventricular restoration for nonischemic dilated cardiomyopathy.
PG  - S207-12
AB  - OBJECTIVE: Left ventricular restoration is used to treat patients with chronic 
      progressive heart failure caused by nonischemic dilated cardiomyopathy. This 
      study addresses the use of site selection to determine either lateral wall or 
      septal exclusion. METHODS: Evolution of intraoperative echocardiography to define 
      the site of poorest contraction and use of multiple biopsies to show the 
      nonhomogeneous nature of damage are reviewed. To address the heterogeneity of 
      extent of fibrosis in nonischemic cardiomyopathy, target selection was used to 
      determine the mode of left ventriculoplasty. Either the lateral wall was excluded 
      by partial left ventriculectomy (PLV) or septal anterior ventricular exclusion 
      (SAVE or Pacopexy) was employed if the septum was primarily diseased. Surgical 
      results in 107 high-risk (43% NYHA (New York Heart Association) class III and 57% 
      class IV) patients with idiopathic dilated cardiomyopathy over the past 9 years 
      are reviewed. RESULTS: Overall hospital mortality was 7.1% in 84 elective 
      operations and 60.9% in 23 emergency operations, and fell from 42.8% (6 of 14) to 
      15.0% (14 of 93), when site selection for the area of left ventricular excision 
      or exclusion was determined by the intraoperative echocardiography test. The 
      SAVE/Pacopexy procedure was performed in 36 patients with 62.2% 5-year survival 
      rate. For the entire cohort of PLV and SAVE/Pacopexy population, overall ejection 
      fraction increased from 20 to 31%, and NYHA class improved from 3.6 to 1.8. The 
      1-, 5-, and 7-year survival rates were 66.9, 46.0, and 36.2%, respectively. In 
      patients having the operation before inotropic dependent, the survival rate was 
      78.1, 58.0, and 50.2%, respectively. CONCLUSIONS: Left ventriculoplasty is 
      effective for patients with idiopathic dilated cardiomyopathy with heart failure 
      by proper patient selection, appropriate timing of the operation, and choice of 
      the surgical procedure (exclusion site selection).
FAU - Suma, Hisayoshi
AU  - Suma H
AD  - The Cardiovascular Institute, Tokyo, Japan.
FAU - Horii, Taiko
AU  - Horii T
FAU - Isomura, Tadashi
AU  - Isomura T
FAU - Buckberg, Gerald
AU  - Buckberg G
CN  - RESTORE Group
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20060329
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/diagnostic imaging/pathology/physiopathology/*surgery
MH  - Female
MH  - Heart Septum/surgery
MH  - Heart Ventricles/diagnostic imaging/pathology/surgery
MH  - Humans
MH  - Intraoperative Care/methods
MH  - Male
MH  - Middle Aged
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Ultrasonography
EDAT- 2006/03/29 09:00
MHDA- 2007/01/11 09:00
CRDT- 2006/03/29 09:00
PHST- 2006/02/17 00:00 [received]
PHST- 2006/02/17 00:00 [revised]
PHST- 2006/02/28 00:00 [accepted]
PHST- 2006/03/29 09:00 [pubmed]
PHST- 2007/01/11 09:00 [medline]
PHST- 2006/03/29 09:00 [entrez]
AID - S1010-7940(06)00244-2 [pii]
AID - 10.1016/j.ejcts.2006.02.063 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2006 Apr;29 Suppl 1:S207-12. doi: 
      10.1016/j.ejcts.2006.02.063. Epub 2006 Mar 29.