PMID- 19740283
OWN - NLM
STAT- MEDLINE
DCOM- 20100930
LR  - 20161125
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 24
IP  - 5
DP  - 2009 Sep-Oct
TI  - Impact of apex-sparing partial left ventriculectomy on left ventricular geometry, 
      function, and long-term survival of patients with end-stage dilated 
      cardiomyopathy.
PG  - 499-502
LID - 10.1111/j.1540-8191.2009.00874.x [doi]
AB  - BACKGROUND AND AIM: Currently, partial left ventriculectomy (PLV) has not been 
      widely accepted as a treatment option for dilated cardiomyopathy (DCM) because 
      its results thus far have been inconsistent. In an animal study, apex-sparing PLV 
      (AS-PLV) was shown to produce greater improvement in left ventricle (LV) function 
      than conventional PLV in which the apex was removed. The aim of this study is to 
      investigate the effectiveness of AS-PLV in a clinical setting. PATIENTS AND 
      METHODS: From September 1999 to December 2007, 13 patients with DCM underwent 
      AS-PLV. Left ventriculotomy was made in the thinnest portion of the lateral wall 
      without injuring the apex, the papillary muscles, and the circumflex coronary 
      artery, which supplies the neighboring myocardium. RESULTS: All patients were 
      discharged from the hospital, except for one patient who developed refractory 
      ventricular fibrillation on postoperative day 35. After AS-PLV, the LV diastolic 
      dimension decreased from 71 +/- 10 mm to 55 +/- 9 mm; LV ejection fraction (EF) 
      from 28%+/- 8% to 39%+/- 11%; and New York Heart Association (NYHA) class from 3 
      +/- 1.7 to 1.5 +/- 0.6; the differences were significant (p < 0.01). LV function 
      and geometry remained unchanged 2 years after AS-PLV with LVDD of 60 +/- 7 mm, 
      LVEF of 34%+/- 8%, and NYHA class of 1.7 +/- 0.6, respectively (N.S vs. at 
      discharge). CONCLUSIONS: Regardless of the etiology of LV dilatation, AS-PLV 
      restored the ellipsoidal shape of the LV and improved LV function. AS-PLV is a 
      feasible option for treating diseased LVs with lateral wall lesions.
FAU - Nishina, Takeshi
AU  - Nishina T
AD  - Department of Cardiovascular Surgery, Kyoto University Hospital, Kyoto, Japan.
FAU - Shimamoto, Takeshi
AU  - Shimamoto T
FAU - Marui, Akira
AU  - Marui A
FAU - Komeda, Masashi
AU  - Komeda M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Cardiac Surgical Procedures
MH  - Cardiomyopathy, Dilated/diagnostic imaging/mortality/pathology/*surgery
MH  - Diastole
MH  - Feasibility Studies
MH  - Female
MH  - Health Status Indicators
MH  - Heart Ventricles/diagnostic imaging/pathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Stroke Volume
MH  - Survival Analysis
MH  - Systole
MH  - Time Factors
MH  - Ultrasonography
MH  - United States
MH  - Ventricular Function, Left
EDAT- 2009/09/11 06:00
MHDA- 2010/10/01 06:00
CRDT- 2009/09/11 06:00
PHST- 2009/09/11 06:00 [entrez]
PHST- 2009/09/11 06:00 [pubmed]
PHST- 2010/10/01 06:00 [medline]
AID - JCS874 [pii]
AID - 10.1111/j.1540-8191.2009.00874.x [doi]
PST - ppublish
SO  - J Card Surg. 2009 Sep-Oct;24(5):499-502. doi: 10.1111/j.1540-8191.2009.00874.x.