No additive effect of passive containment surgery in patients with aortic regurgitation and left ventricular dilation.
BACKGROUND
After valve replacement in patients with aortic regurgitation short-term and long-term improvement of left ventricular function are related to early reduction of left ventricular dilatation. This case-control study was conducted to investigate the potential beneficial effects by concomitant application of the Acorn Cor Cap Cardiac Support Device (Acorn Cardiovascular Inc, St. Paul, MN) on reduction of ventricular dilatation in patients with aortic regurgitation and advanced ventricular dilatation undergoing aortic valve replacement.


METHODS
Of ten patients with longstanding aortic regurgitation and ventricular dilatation subjected to aortic valve replacement using mechanical valve prostheses, five were in addition subjected to application of the Cardiac Support Device (Acorn). Cardiac function and dimensions were measured by echocardiography preoperatively and 3 and 12 months postoperatively.


RESULTS
After aortic valve replacement, there was a rapid and sustained decrease in end-diastolic and end-systolic diameters (before operation 72 +/- 4 and 54 +/- 8 mm, to 54 +/- 10 and 40 + 11 mm at 3 months; and 53 +/- 9 and 35 +/- 6 mm, 12 months after operation). This did not differ after Cardiac Support Device (Acorn) application (before operation 74 +/- 1 and 56 +/- 5 mm; 52 +/- 8 and 39 +/- 9 mm, 3 months after operation; and 54 +/- 6 and 39 +/- 8 mm, at 12 months). The left ventricular ejection fraction remained unchanged in both groups.


CONCLUSIONS
Application of the Acorn Cor Cap Cardiac Support Device in patients with aortic regurgitation and severe ventricular dilatation does not influence reverse remodeling or cardiac function compared with aortic valve replacement alone.
Bredin
Fredrik
F
Section of Cardiothoracic Surgery and Anaesthesiology, Institution of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. fredrik.bredin@karolinska.se
Olsson
Arne
A
Franco-Cereceda
Anders
A
D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data*; D003971:Diastole; D006353:Heart-Assist Devices; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013599:Systole; D016896:Treatment Outcome; D014664:Vasodilation; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology / Q000601:surgery*