Endoventricular patch reconstruction in large ischemic wall-motion abnormalities.
Endoventricular patch plasty (EVPP) has been used since 1984 to rebuild the left ventricle. The global experience of our group includes more than 835 cases. Large wall-motion abnormalities were detected by the center line method when > 60% of the circumference of the left ventricle was asynergic. In this series, 269 patients had an ejection fraction < 30%. Surgery for repair of large wall-motion abnormalities was conducted on the arrested heart with insertion within the left ventricle of a patch rebuilding the contractile area while leaving a residual volume between 50 and 70 cc/m2 of body surface. The global results of the technique of EVPP are analyzed on the last 700 operated patients. Three series of patients with large wall-motion abnormalities were examined. We conclude that this technique is appropriate in advanced stages of ischemic disease as an alternative to cardiac transplant. At an operative risk of approximately 12%, improvement is obtained in 80% of cases.
Dor
V
V
The Centre Cardio-Thoracique, Monaco. vdor@ccm.mc
Sabatier
M
M
Montiglio
F
F
Coste
P
P
Di Donato
M
M
D019917:Blood Vessel Prosthesis Implantation; D002311:Cardiomyopathy, Dilated / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006322:Heart Aneurysm / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006324:Heart Arrest, Induced; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome