Changes in left ventricular morphology and function in end-stage dilated cardiomyopathy after reductive annuloplasty of double mitral and tricuspid orifices.
OBJECTIVE
The aim of this study is to show the changes in left ventricular morphology and function after reductive annuloplasty of double mitral and tricuspid orifices (RADO) in ischemic dilated cardiomyopathy (IDCM) and primary dilated cardiomyopathy (PDCM) analyzed by intraoperative transesophageal echocardiography (TEE).


METHODS
There were 274 patients, mean age 50.1 years, 188 operated due to IDCM with ejection fraction under 30%, and 86 patients due to PDCM. Mitral annuloplasty according to A. Carpentier and our own procedure was done in 49 and 225 patients, respectively. In 265 cases (97%) our modified De Vega's tricuspid annuloplasty was performed.


RESULTS



CONCLUSIONS
RADO significantly changes left ventricular morphology, reverses remodeling of the heart, decreases sphericity of the left heart, improves hemodynamic function of both ventricles, and slows down progression of cardiac failure. We recommend RADO in the early stage of PDCM, immediately after the first decompensation, and as an important associated procedure in IDCM.
Radovanovic
N
N
University Clinic of Cardiovascular Surgery, Novi Sad, Yugoslavia. nradov@eunet.yu
Petrovic
L J
LJ
Zorc
M
M
Mihajilovic
B
B
Kovac
M
M
Nicin
S
S
Popov
M
M
Torbica
V
V
Uscumlic-Kovacevic
D
D
D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D017548:Echocardiography, Transesophageal; D005112:Extracorporeal Circulation; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D016277:Ventricular Function, Left / Q000502:physiology*