PMID- 17491350
OWN - NLM
STAT- MEDLINE
DCOM- 20071030
LR  - 20181113
IS  - 1863-6705 (Print)
IS  - 1863-6705 (Linking)
VI  - 55
IP  - 4
DP  - 2007 Apr
TI  - Surgical ventricular restoration based on evaluation of myocardial viability with 
      delayed-enhanced magnetic resonance imaging.
PG  - 149-57; discussion 157
AB  - OBJECTIVE: We examined whether the determination of myocardial viability by 
      preoperative delayed-enhanced magnetic resonance imaging (DE-MRI) would be useful 
      for planning surgical ventricular restoration (SVR). METHODS: Eight consecutive 
      patients with poor cardiac function (ejection fraction < 30%) due to ischemic 
      cardiomyopathy underwent surgical treatment based on findings of preoperative 
      cine-MRI and DE-MRI. Our surgical strategy consisted of (1) complete 
      revascularization on viable segments; (2) SVR in a patient with extensive 
      nonviable segments; and (3) mitral valve plasty in a patient with a more than 
      moderate degree of mitral regurgitation. Based on the MRI assessments, four of 
      the patients (group A) underwent isolated coronary bypass surgery, and the other 
      four (group B) underwent SVR and mitral valve plasty concomitantly with coronary 
      bypass surgery. Perioperative changes in ventricular function were quantitatively 
      assessed in each group. RESULTS: The mean end-diastolic volume index was reduced 
      from 115 +/- 29 ml/m2 to 95 +/- 14ml/m2 in group A and from 163 +/- 35ml/m2 to 
      125 +/- 28ml/m2 in group B. The mean end-systolic volume index was reduced from 
      91 +/- 25ml/m2 to 68 +/- 16ml/m2 in group A and from 135 +/- 36ml/m2 to 98 +/- 28 
      ml/m2 in group B. The mean ejection fraction increased from 20% +/- 6% to 28% +/- 
      9% in group A and from 17% +/- 6% to 22% +/- 5% in group B. The mean New York 
      Heart Association (NYHA) functional class was reduced from 3.0 +/- 0.8 to 1.8 +/- 
      0.6 in group A and from 3.5 +/- 0.5 to 2.2 +/- 0.2 in group B. CONCLUSION: DE-MRI 
      was highly effective in helping to select which patients and which areas of the 
      left ventricle are indicated for SVR, which contributed to excellent early 
      clinical outcomes.
FAU - Ogawa, Mitsugu
AU  - Ogawa M
AD  - Department of Cardiovascular and Thoracic Surgery, Kyoto Prefectural University 
      of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Japan. 
      m-ogawa@koto.kpu-m.ac.jp
FAU - Doi, Kiyoshi
AU  - Doi K
FAU - Yamada, Yoshiaki
AU  - Yamada Y
FAU - Fukumoto, Atsushi
AU  - Fukumoto A
FAU - Okawa, Kazunari
AU  - Okawa K
FAU - Kan'bara, Tamotsu
AU  - Kan'bara T
FAU - Koushi, Keitarou
AU  - Koushi K
FAU - Itoh, Hirotshi
AU  - Itoh H
FAU - Nishimura, Tsunehiko
AU  - Nishimura T
FAU - Yaku, Hitoshi
AU  - Yaku H
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Gen Thorac Cardiovasc Surg
JT  - General thoracic and cardiovascular surgery
JID - 101303952
SB  - IM
MH  - Cardiomyopathies/*diagnosis/*surgery
MH  - Female
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - *Tissue Survival
EDAT- 2007/05/12 09:00
MHDA- 2007/10/31 09:00
CRDT- 2007/05/12 09:00
PHST- 2007/05/12 09:00 [pubmed]
PHST- 2007/10/31 09:00 [medline]
PHST- 2007/05/12 09:00 [entrez]
AID - 10.1007/s11748-006-0091-5 [doi]
PST - ppublish
SO  - Gen Thorac Cardiovasc Surg. 2007 Apr;55(4):149-57; discussion 157. doi: 
      10.1007/s11748-006-0091-5.