PMID- 24210622
OWN - NLM
STAT- MEDLINE
DCOM- 20140401
LR  - 20140203
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 97
IP  - 2
DP  - 2014 Feb
TI  - Posterior restoration of left ventricle and mitral valve repair in patients with 
      muscular dystrophy.
PG  - 577-81
LID - S0003-4975(13)02113-9 [pii]
LID - 10.1016/j.athoracsur.2013.09.030 [doi]
AB  - BACKGROUND: Congestive heart failure (CHF) is major risk factor for survival 
      among patients with muscular dystrophy (MD). The degenerative postero-lateral 
      wall of the left ventricle (LV), which results in systolic dysfunction and 
      functional mitral regurgitation (MR) at the time of CHF, is not well described in 
      MD. METHODS: We restored the LV and repaired the mitral valves of 6 patients 
      (mean age, 43 +/- 9 years) during emergency and elective procedures. Two and 4 
      patients were in New York Heart Association (NYHA) functional classes III and IV, 
      respectively. One patient required emergency preoperative intraaortic balloon 
      pump support. Before operation, speckle-tracking echocardiography was applied to 
      detect the myocardial lesion. The postero-lateral LV wall that is critically 
      affected in MD was excluded during posterior restoration. Functional MR was 
      repaired using a combination of ring annuloplasty, papillary muscle 
      approximation, and chordal cutting. The LV myocardium between the end of the LV 
      incision line and the mitral annulus was cryoablated to prevent late ventricular 
      arrhythmia. RESULTS: All patients survived (100%) for a mean follow-up of 59+/-39 
      (range; 5 to 101) months. The NYHA functional classes improved to I and II (n=3 
      each). Left ventricular end-diastolic diameter significantly decreased from 77+/-13 
      to 59+/-4 mm (p=0.0088), whereas ejection fraction did not significantly improve 
      (0.24+/-0.1 vs 0.29+/-0.11, p=0.2451), although MR severity was significantly 
      eliminated (3.5+/-0.5 vs 0.5+/-0.6, p=0.0003). No cardiac events were associated with 
      CHF or arrhythmia during follow-up. CONCLUSIONS: Posterior restoration of the LV 
      and mitral repair are useful for treating CHF in patients with MD, and improve 
      survival.
CI  - Copyright (c) 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Hirota, Masanori
AU  - Hirota M
AD  - Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa, Japan. 
      Electronic address: hirota@hayamaheart.gr.jp.
FAU - Hoshino, Joji
AU  - Hoshino J
AD  - Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa, Japan.
FAU - Fukada, Yasuhisa
AU  - Fukada Y
AD  - Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa, Japan.
FAU - Kondo, Taichi
AU  - Kondo T
AD  - Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa, Japan.
FAU - Takahashi, Yu
AU  - Takahashi Y
AD  - Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa, Japan.
FAU - Notomi, Yuichi
AU  - Notomi Y
AD  - Department of Cardiovascular Medicine, Hayama Heart Center, Kanagawa, Japan.
FAU - Isomura, Tadashi
AU  - Isomura T
AD  - Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa, Japan.
LA  - eng
PT  - Journal Article
DEP - 20131107
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adult
MH  - Cardiac Surgical Procedures/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*complications/*surgery
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*complications/*surgery
MH  - Muscular Dystrophies/*complications
OTO - NOTNLM
OT  - 18
OT  - 35
EDAT- 2013/11/12 06:00
MHDA- 2014/04/02 06:00
CRDT- 2013/11/12 06:00
PHST- 2013/06/26 00:00 [received]
PHST- 2013/09/06 00:00 [revised]
PHST- 2013/09/10 00:00 [accepted]
PHST- 2013/11/12 06:00 [entrez]
PHST- 2013/11/12 06:00 [pubmed]
PHST- 2014/04/02 06:00 [medline]
AID - S0003-4975(13)02113-9 [pii]
AID - 10.1016/j.athoracsur.2013.09.030 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2014 Feb;97(2):577-81. doi: 10.1016/j.athoracsur.2013.09.030. 
      Epub 2013 Nov 7.