Early Results and Operative Considerations of Endoventricular Circular Patch Plasty for Ischemic Cardiomyopathy

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概要

• 論文の詳細を見る

• Seven patients with ischemic cardiomyopathy who underwent elective endoventricular circular patch plasty (EVCPP) were included in this study. The mean age of the patients at the time of surgery was 63 years old. All seven patients had anterior left ventricular aneurysms following old myocardial infarction. Two patients were graded NYHA class II, 4 patients class III, and one patient class IV. EVCPP was performed under cardiac arrest with moderate hypothermia in five patients. The two most recent patients underwent EVCPP under on-pump beating and normothermia. Coronary artery bypass grafting was conducted in all cases and the mean number of grafts was 1.8, ranging from one to three. The mitral valve was replaced in one patient. One patient died of myonephrotic metabolic syndrome caused by ischemia of the lower limb. In the follow-up of six patients, the left ventricular end-diastolic volume index (LVEDI) decreased significantly from 128±31 mL/m2 to 108±37 mL/m2. Left ventricular end-systolic volume index (LVESI) decreased in five patients. Left ventricular end-diastolic and end-systolic diameter remained unchanged after surgery. The left ventricular ejection fraction (LVEF) increased from 0.28±0.08 to 0.32±0.1. LVESI and LVEF did not improve in one patient with a large residual dyskinetic area at the distal LV septum. A residual dyskinetic area at the distal LV septum was observed in two of four patients who underwent EVCPP under cardiac arrest. This condition, however, was not detected in two patients who underwent EVCPP under on-pump beating conditions. In the follow-up study, the grade of NYHA functional classification improved in all six patients. In conclusion, EVCPP under on-pump beating is a realistic and effective procedure with which to complete ideal LV geometry and promote good results in patients with ischemic cardiomyopathy.

• Japanese Heart Journal Associationの論文

著者

• ISHIKAWA Susumu

  Second Department of Surgery, Gunma University School of Medicine

• MORISHITA Yasuo

  Second Department of Surgery, Gunma University School of Medicine

• Oshima Kiyohiro

  Second Department of Surgery, Gunma University Faculty of Medicine

• Aizaki Masahiro

  Second Department of Surgery, Gunma University Faculty of Medicine

• Takahashi Toru

  Second Department of Surgery, Gunma University Faculty of Medicine

• Hasegawa Yutaka

  Second Department of Surgery, Gunma University Faculty of Medicine

• Sato Yasushi

  Second Department of Surgery, Gunma University Faculty of Medicine

• Koyano Tetsuya

  Second Department of Surgery, Gunma University Faculty of Medicine

• Mohara Jun

  Second Department of Surgery, Gunma University Faculty of Medicine

• Suzuki Masao

  Second Department of Surgery, Gunma University Faculty of Medicine

• Sato Yasushi

  Second Department Of Surgery Gunma University Faculty Of Medicine

• Koyano Tetsuya

  Second Department Of Surgery Gunma University School Of Medicine

• Takahashi Toru

  Second Department Of Internal Medicine (cardiology) Sapporo Medical University School Of Medicine

• Ishikawa Susumu

  Second Department Of Surgery Gunma University Graduate School Of Medicine

• Morishita Yasuo

  Second Department Of Surgery

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