Left ventricular reconstruction by modified linear technique with absorbable suture.
BACKGROUND
Linear and endoventricular techniques of left ventricular (LV) reconstruction often utilise prosthetic material for epicardial reinforcement or endocardial patch. We report a technique of LV aneurysm repair using absorbable suture without prosthetic material.


METHODS
Between November 1999 and August 2004, 55 patients underwent linear LV reconstruction, for ischaemic cardiomyopathy, using only continuous 3/0 polydioxanone suture. Survival, functional class and echocardiographic outcomes are reported.


RESULTS
Fifty-two patients (mean age 64+/-10 years) were studied. There was no perioperative mortality and the Kaplan-Meier survival at five years was 81%. Fifty-one patients underwent postoperative follow up (mean 28 months) with echocardiography (mean 20 months). There were no recurrent aneurysms. The postoperative LV eccentricity index (EI) was 0.72 (CI 0.48-0.9). Mean LV ejection fraction increased from 0.33+/-0.09 preoperatively to 0.41+/-0.15 at late follow up (mean within patient change 0.08+/-0.15, p=0.003). Mean symptom class improved from 3.3+/-0.8 to 1.6+/-0.7 (mean within patient improvement 1.6+/-1.0, p<0.001). Mitral regurgitation of grade 2/4 was identified in six patients and grade 3/4 in one patient.


CONCLUSIONS
Linear repair with absorbable suture material and without prosthetic material may be safely undertaken with good early and mid-term results.
Bennetts
Jayme S
JS
Department of Cardiothoracic Surgery, Westmead Hospital, Sydney West Area Health Service, Hawkesbury Road, Westmead, NSW 2145, Australia.
Byth
Karen
K
Morris
Michael
M
Paterson
Hugh S
HS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery*; D016687:Polydioxanone; D012189:Retrospective Studies; D013536:Suture Techniques; D016277:Ventricular Function, Left
D016687:Polydioxanone