PMID- 23462259
OWN - NLM
STAT- MEDLINE
DCOM- 20130514
LR  - 20161125
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 95
IP  - 4
DP  - 2013 Apr
TI  - Role of surgical ventricular restoration in the treatment of ischemic 
      cardiomyopathy.
PG  - 1315-21
LID - S0003-4975(13)00079-9 [pii]
LID - 10.1016/j.athoracsur.2012.12.035 [doi]
AB  - BACKGROUND: Surgical ventricular restoration (SVR) has been applied as a valuable 
      adjunct procedure for patients undergoing coronary artery bypass grafting (CABG) 
      to correct the geometry of the left ventricle on the basis of myocardial 
      revascularization. It is necessary to find out at least which patient cohort is 
      more likely to benefit from this procedure. METHODS: A case-control study was 
      conducted on 221 patients with ejection fraction (EF)</=0.35 and New York Heart 
      Association (NYHA) class III or IV, who received CABG+SVR or CABG alone from 1998 
      to 2008. Comparisons were made between CABG+SVR and CABG alone within two groups 
      of patients: group 1 (preoperative left ventricular end-systolic volume index 
      [LVESVI]<80 mL/m2, n=127) and group 2 (preoperative LVESVI>/=80 mL/m2, n=94). 
      Outcomes included improvement in EF, NYHA class, readmissions, and survival. 
      RESULTS: Patients in either group receiving SVR achieved significant LVESVI 
      reduction postoperatively (p<0.001). In group 1, EF improvement (defined as over 
      .05 improvement in EF) was observed in 53.7% of CABG+SVR patients compared with 
      48.5% for CABG patients (p 0.570). A similar percentage of patients improved to 
      NYHA class I or II (63.0% for CABG+SVR versus 55.9% for CABG, p=0.430). 
      Readmissions after CABG+SVR were 27.8% compared with 38.2% after CABG (p=0.225). 
      There was no difference in survival between CABG+SVR and CABG (p=0.709). In group 
      2, the CABG+SVR patients showed greater EF improvement (55.6% versus 30.8%, 
      p=0.020) and were more likely to improve to NYHA class I or II (58.3% versus 
      36.5%, p=0.044). Readmissions were fewer for the CABG+SVR patients than for the 
      CABG patients (30.6% versus 57.7%, p=0.012). CABG+SVR yielded better survival 
      than did CABG (p=0.031). CONCLUSIONS: Patients with much advanced LVESVI are more 
      likely to benefit from surgical ventricular restoration, and this surgical 
      procedure still holds its ground in the treatment of ischemic cardiomyopathy.
CI  - Copyright (c) 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Liu, Jun
AU  - Liu J
AD  - Department of Cardiovascular Surgery, Ruijin Hospital Affiliated to Shanghai Jiao 
      Tong University School of Medicine, Shanghai, China.
FAU - Liu, Zixiong
AU  - Liu Z
FAU - Zhao, Qiang
AU  - Zhao Q
FAU - Chen, Anqing
AU  - Chen A
FAU - Wang, Zhe
AU  - Wang Z
FAU - Zhu, Dan
AU  - Zhu D
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20130222
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2013 Apr;95(4):1321-2. PMID: 23522198
MH  - Cardiac Surgical Procedures/*methods
MH  - Cardiomyopathies/diagnostic imaging/physiopathology/*surgery
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Ventricles/diagnostic imaging/physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/diagnostic imaging/physiopathology/*surgery
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Function, Left/*physiology
EDAT- 2013/03/07 06:00
MHDA- 2013/05/15 06:00
CRDT- 2013/03/07 06:00
PHST- 2012/10/19 00:00 [received]
PHST- 2012/12/06 00:00 [revised]
PHST- 2012/12/07 00:00 [accepted]
PHST- 2013/03/07 06:00 [entrez]
PHST- 2013/03/07 06:00 [pubmed]
PHST- 2013/05/15 06:00 [medline]
AID - S0003-4975(13)00079-9 [pii]
AID - 10.1016/j.athoracsur.2012.12.035 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2013 Apr;95(4):1315-21. doi: 10.1016/j.athoracsur.2012.12.035. 
      Epub 2013 Feb 22.