Experimental study of a new operative procedure for nonischemic dilated cardiomyopathy: overlapping cardiac volume reduction operation.
OBJECTIVE
To assess a newly devised procedure for cardiac volume reduction without resecting any cardiac muscle and evaluate its effectiveness in an experimental settings.


METHODS
Ten beagle dogs underwent a rapid pacing leading to heart failure for 3 weeks and then underwent left ventricular reduction by a procedure called the overlapping cardiac volume reduction operation (OLCVR), which consisted of a longitudinal incision in the left ventricular (LV) free wall, sutures from the left margin to the septal wall, and the right margin to the LV free wall. A slope of the linear preload recruitable stroke work relationship ( M(w)), with an X-intercept ( V(o)) were calculated as precise indicators of the LV systolic function. The constant of isovolumic pressure decay (Tau) and the peak filling rate (PFR) were also calculated as indicators of the LV diastolic function.


RESULTS
The LV end-diastolic dimensions significantly decreased by OLCVR (43 +/- 2 to 25 +/- 1 mm). Fractional shortening significantly improved by OLCVR (11% +/- 2% to 30% +/- 4%). M(w) (erg. cm(-3). 10(3)) also significantly improved (21 +/- 2 to 33 +/- 3 ( P < 0.001)), whereas V(o), Tau, and PFR did not show any significant changes.


CONCLUSIONS
The OLCVR significantly increased the early LV systolic function without any detrimental effects on the diastolic function. This procedure may therefore be a useful therapeutic option for end-stage cardiomyopathy.
Luo
Bin
B
Department of Cardiovascular Surgery, Hokkaido University School of Medicine, North 14 West 5, Sapporo 060-8648, Japan.
Matsui
Yoshiro
Y
Suto
Yukio
Y
Fukada
Yasuhisa
Y
Sasaki
Shigeyuki
S
Yasuda
Keishu
K
D000818:Animals; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology / Q000601:surgery*; D004285:Dogs; D011184:Postoperative Period; D016277:Ventricular Function, Left