PMID- 20194031
OWN - NLM
STAT- MEDLINE
DCOM- 20110418
LR  - 20191210
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 38
IP  - 2
DP  - 2010 Aug
TI  - Indication of posterior restoration and surgical results in patients with dilated 
      cardiomyopathy.
PG  - 171-5
LID - 10.1016/j.ejcts.2009.12.028 [doi]
AB  - OBJECTIVE: Nontransplant surgery for dilated cardiomyopathy (DCM) has been in the 
      process of development. Anterior restoration for anterior akinesis has shown 
      favourable outcome. Posterior restoration and surgical results are also 
      discussed. METHODS: At the Hayama Heart Center in Japan, between 2005 and 2009, 
      posterior restoration for DCM was performed in 36 patients (10 with ischaemic and 
      26 with nonischaemic, including muscular dystrophy in three). There were 32 men 
      and four women with a mean age of 53 years. The mean preoperative ejection 
      fraction was 23% and the preoperative New York Heart Association (NYHA) 
      classification was class III in 16 patients and class IV in 20 with eight 
      emergent operations. To identify the posterior lesion before operation, 
      speckle-tracking echocardiography was used, with a Vivid 7 ultrasound machine. 
      The short-axis images from the middle level of the left ventricle (LV) were 
      obtained to assess myocardial segmental viability. Based on the results of 
      speckle-tracking echocardiography, posterior restoration was performed in 
      patients with postero-lateral akinesis and septal kinesis. After the cardioplegic 
      arrest, mitral plasty or coronary artery bypass grafting (CABG) was performed and 
      the posterior LV muscle between bilateral papillary muscles was partially 
      resected under beating heart. The LV apex was preserved and cryoablation was 
      applied between the cut edge and the mitral annulus. All the patients were 
      followed with cardiac echocardiography. RESULTS: In addition to LV restoration, 
      mitral plasty was successfully performed in all the patients. Concomitant CABG 
      was performed in seven, tricuspid surgery in 11 and cardiac resynchronisation 
      therapy (CRT) in eight. Perioperative intra-aortic balloon pumping (IABP) was 
      used in six and there was no hospital mortality, including eight emergent 
      operations. After the operation, 29 patients (80.6%) improved their functional 
      class into class I or II. In the late follow-up, there were two cardiac deaths 
      and one noncardiac death and the 4-year survival rate was 85.8%. CONCLUSIONS: The 
      site selection with speckle-tracking echocardiography demonstrated the accurate 
      akinetic lesion of the posterior LV wall. The posterior restoration with 
      preservation of bilateral papillary muscles and LV apex based on the site 
      selection improved operative and mid-term results in the selected patients with 
      DCM.
CI  - Copyright 2010 European Association for Cardio-Thoracic Surgery. Published by 
      Elsevier B.V. All rights reserved.
FAU - Isomura, Tadashi
AU  - Isomura T
AD  - Hayama Heart Center, Kanagawa, Japan. t-isomura@hayamaheart.gr.jp
FAU - Notomi, Yuichi
AU  - Notomi Y
FAU - Hoshino, Jyoji
AU  - Hoshino J
FAU - Fukada, Yasuhisa
AU  - Fukada Y
FAU - Katahira, Sintarou
AU  - Katahira S
FAU - Kitamura, Aki
AU  - Kitamura A
FAU - Kondo, Taichi
AU  - Kondo T
FAU - Iwasaki, Tomoaki
AU  - Iwasaki T
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20100302
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/diagnosis/physiopathology/*surgery
MH  - Coronary Artery Bypass
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Image Interpretation, Computer-Assisted/methods
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Annuloplasty/methods
MH  - Mitral Valve Insufficiency/physiopathology/surgery
MH  - Stroke Volume/physiology
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Ventricular Function, Left/physiology
MH  - Young Adult
EDAT- 2010/03/03 06:00
MHDA- 2011/04/19 06:00
CRDT- 2010/03/03 06:00
PHST- 2009/10/12 00:00 [received]
PHST- 2009/12/06 00:00 [revised]
PHST- 2009/12/10 00:00 [accepted]
PHST- 2010/03/03 06:00 [entrez]
PHST- 2010/03/03 06:00 [pubmed]
PHST- 2011/04/19 06:00 [medline]
AID - S1010-7940(09)01208-1 [pii]
AID - 10.1016/j.ejcts.2009.12.028 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2010 Aug;38(2):171-5. doi: 10.1016/j.ejcts.2009.12.028. 
      Epub 2010 Mar 2.