PMID- 17448414
OWN - NLM
STAT- MEDLINE
DCOM- 20070612
LR  - 20071115
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 13
IP  - 3
DP  - 2007 Apr
TI  - Clinical efficacy of surgical heart failure therapy by ventricular restoration 
      and restrictive mitral annuloplasty.
PG  - 178-83
AB  - BACKGROUND: Treatment of heart failure by advanced surgical procedures such as 
      ventricular restoration (SVR) and restrictive mitral annuloplasty (RMA) is 
      increasingly applied. We studied clinical efficacy of heart failure surgery in 
      patients with severe heart failure. METHODS AND RESULTS: Thirty-three patients 
      (New York Heart Association (NYHA) class III/IV, left ventricular ejection 
      fraction < or =35%) were included. Patients with moderate to severe mitral 
      regurgitation underwent RMA (85%) and patients with anteroseptal aneurysm 
      underwent SVR (52%). A combined procedure was performed in 12 patients, and 
      additional coronary artery bypass grafting in 27 patients. Clinical and 
      echocardiographic parameters were assessed at baseline and 6 months after 
      surgery. Operative mortality was 3% (n = 1), in-hospital mortality was 9% (n = 
      3), and there was no late mortality. All clinical parameters were significantly 
      improved at 6 months' follow-up (P < .001); NYHA class improved from 3.4 +/- 0.5 
      to 1.5 +/- 0.5, Quality-of-life score improved from 44 +/- 22 to 16 +/- 12, and 
      6-minute walking distance increased from 248 +/- 134 m to 422 +/- 113 m. Left 
      ventricular end-diastolic volume decreased from 107 +/- 32 to 80 +/- 20 mL/m(2) 
      (P < .001) and end-systolic volume decreased from 78 +/- 32 to 53 +/- 15 mL/m(2) 
      (P < .001), whereas ejection fraction improved from 29 +/- 9 to 35 +/- 7% (P < 
      .01). CONCLUSIONS: Surgical treatment of severe heart failure by SVR or RMA was 
      associated with 12% mortality at 6 months. Surviving patients showed highly 
      significant functional and clinical improvements.
FAU - Tulner, Sven A
AU  - Tulner SA
AD  - Departments of Cardio-Thoracic Surgery, Leiden University Medical Center, Leiden, 
      The Netherlands.
FAU - Steendijk, Paul
AU  - Steendijk P
FAU - Klautz, Robert J
AU  - Klautz RJ
FAU - Tops, Laurens
AU  - Tops L
FAU - Bax, Jeroen J
AU  - Bax JJ
FAU - Versteegh, Michel I
AU  - Versteegh MI
FAU - Verwey, Harriette F
AU  - Verwey HF
FAU - Schalij, Martin J
AU  - Schalij MJ
FAU - van der Wall, Ernst E
AU  - van der Wall EE
FAU - Dion, Robert A
AU  - Dion RA
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Exercise Tolerance
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*complications/diagnosis/physiopathology/*surgery
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/diagnosis/*etiology/physiopathology/*surgery
MH  - Quality of Life
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*etiology/physiopathology/*surgery
MH  - Ventricular Function, Left
EDAT- 2007/04/24 09:00
MHDA- 2007/06/15 09:00
CRDT- 2007/04/24 09:00
PHST- 2006/08/17 00:00 [received]
PHST- 2006/11/21 00:00 [revised]
PHST- 2006/11/21 00:00 [accepted]
PHST- 2007/04/24 09:00 [pubmed]
PHST- 2007/06/15 09:00 [medline]
PHST- 2007/04/24 09:00 [entrez]
AID - S1071-9164(06)01253-X [pii]
AID - 10.1016/j.cardfail.2006.11.010 [doi]
PST - ppublish
SO  - J Card Fail. 2007 Apr;13(3):178-83. doi: 10.1016/j.cardfail.2006.11.010.