HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A. Bockeria Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bockeria, L. A. Search for Related Content PubMed PubMed Citation Articles by Bockeria, L. A. Related Collections Cardiac - physiology Congestive Heart Failure Coronary disease

Eur J Cardiothorac Surg 2006;29:S251-S258
© 2006 Elsevier Science NL

Left ventricular geometry reconstruction in ischemic cardiomyopathy patients with predominantly hypokinetic left ventricle

^a Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

Received 2 February 2006; accepted 8 February 2006.

^_* Corresponding author. Address: Bakoulev Center for Cardiovascular Surgery, 135 Roublevskoye Shosse, Moscow, Russia, 121552. Tel.: +7 095 978 0645. (Email: alshibaya{at}mail.ru).

Objective: The effectiveness of the left ventricle (LV) geometry reconstruction (Dor procedure) as the method of surgical treatment of LV post-infarction aneurysm and large dilated myocardial scars is well established. The efficacy of LV restoration in cases of globally dilated hypofunctional LV, containing the same spherical architecture as scarred, remains questionable. Methods: The results of LV geometry reconstruction in small population of patients with ischemic dilated cardiomyopathy (IDCMP) and predominantly hypokinetic LV are described in 14 patients of that underwent LV rebuilding into a conical architecture. Surgical procedures included LV geometry reconstruction with the synthetic patch, narrowing of widened dimensions between papillary muscles, coronary artery bypass grafting (CABG) and, in several cases, mitral and tricuspid valves annuloplasty. Results: Initial mean end-diastolic and end-systolic volumes indexes were 177 and 112 ml/m², respectively, mean LV ejection fraction (EF) of 32.9%. The analysis of immediate and mid-term (1 and 4 years) results proved that LV reconstruction markedly decreased LV volumes and increased LVEF an average of +12% above resting values with significant improvement in clinical status. Conclusions: A rebuilding procedure for the scarred heart is now introduced to be used in ischemic patients with dilated ischemic cardiomyopathy without significant scar. Preliminary structural and physiological results imply that creating an elliptical form has potential importance during LV reconstruction of very sick patients with IDCMP without discrete scar.

Key Words: Congestive heart failure • Ischemic cardiomyopathy • Hypokinesia • Left ventricular reconstruction • Mitral regurgitation • Spiral flows

This article has been cited by other articles:

				G. D. Buckberg Congestive heart failure: Treat the disease, not the symptom Return to normalcy/Part II-The experimental approach. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 844 - 849. [Full Text] [PDF]

				G. D. Buckberg and the RESTORE Group Form versus disease: optimizing geometry during ventricular restoration Eur. J. Cardiothorac. Surg., April 1, 2006; 29(Suppl_1): S238 - S244. [Abstract] [Full Text] [PDF]