Early and mid-term results of left ventricular volume reduction surgery for dilated cardiomyopathy.
OBJECTIVE
To evaluate structure-oriented left ventricular volume reduction surgery (LVVRS). The purpose of this study was to report the early and mid-term results of left volume reduction surgery for dilated cardiomyopathy (DCM).


METHODS
We performed LVVRS on 29 patients with DCM. The age of the patient ranged from 8 to 73 years (mean 58 +/- 18 years). There were 19 male patients (63%). Twenty-three patients were ischemic, 5 were non-ischemic, and 1 had salcoidosis. Twenty-three patients were in New York Heart Association class III or IV. Fourteen patients underwent the Dor operation, 11 underwent a septal anterior ventricular exclusion operation, and 6 underwent a modified Batista operation. Fifteen patients underwent mitral annuloplasty and 2 patients had mitral valve replacement. All patients were divided into two groups, a Dor group (n = 14) and non-Dor group (n = 15). Postoperative early results and mid-term survival rate were compared between the two groups.


RESULTS
Hospital mortality was 13.8% (4/29). The causes of death were low-output syndrome (n = 3) and septic shock (n = 1). Survival rate was 80% at 1 year and 72% at 3 years. Two-year survival rate of Dor and non-Dor groups were 69.8% and 93.8%, respectively (p = 0.099).


CONCLUSIONS
Early and mid-term results of LVVRS were satisfied, and the non-Dor operation tended to be superior in mid-term survival to the Dor operation. Long-term follow-up is warranted.
Koyama
Tadaaki
T
Department of Cardiovascular Surgery, Kyoto University, Graduate School of Medicine, Sakyo-ku Kyoto, Japan.
Nishina
Takeshi
T
Ono
Nobuhisa
N
Sakakibara
Yutaka
Y
Nemoto
Shintaro
S
Ikeda
Tadashi
T
Komeda
Masashi
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002306:Cardiac Volume; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology* / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000601:surgery; D012720:Severity of Illness Index; D013318:Stroke Volume; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome