Post-operative outcome of ventricular reshaping by septal exclusion in patients with severe left ventricular dysfunction.
BACKGROUND
Post-myocardial infarction, anteroseptal dysfunction or akinesia is treated by septal reshaping to improve the surgical outcome in patients with severe left ventricular dysfunction.


RESULTS
Between February 2003 to December 2003, 30 consecutive patients with previous anterior wall myocardial infarction and severe ventricular dysfunction underwent septal reshaping. All the dyskinetic and akinetic septal areas were excluded using an oval dacron patch which was sutured from the healthy septal area to the anterior wall, resulting in formation of a new apex. There were two mortalities in the group. After a mean follow-up of 4.2 +/- 1.6 months (1-7 months) it was seen that this procedure resulted in significant reduction of ventricular volume, increase in ejection fraction, an improvement in New York Heart Association class from 2.9 +/- 1.1 to 1.7 +/- 0.3, and a better apical geometry.


CONCLUSIONS
In selected patients with left anterior descending artery occlusion resulting in anteroseptal dyskinesia or akinesia, septal exclusion technique provides good clinical and morphological results with significant improvement in left ventricular function.
Kohli
Vijay
V
Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, New Delhi. vijay_k22@hotmail.com
Wasir
Harpreet
H
Mittal
Sanjay
S
Karlekar
Anil
A
Mehta
Yatin
Y
Trehan
Naresh
N
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D002306:Cardiac Volume; D005260:Female; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000601:surgery*; D019736:Prostheses and Implants; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000601:surgery*