Endoventricular patch plasty for dyskinetic anteroapical left ventricular aneurysm increases systolic circumferential shortening in sheep.
OBJECTIVE
Endoventricular patch plasty (Dor procedure) has gained favor as a surgical treatment for heart failure associated with large anteroapical myocardial infarction. We tested the hypotheses that the Dor procedure increases systolic circumferential shortening and longitudinal shortening in noninfarcted left ventricular regions in sheep.


METHODS
In 6 male Dorsett sheep, the left anterior descending coronary artery and its second diagonal branch were ligated 40% of the distance from the apex to the base. Sixteen weeks after myocardial infarction, a Dor procedure was performed with a Dacron patch that was 50% of the infarct neck dimension. Two weeks before and 2 and 6 weeks after the Dor procedure, animals underwent magnetic resonance imaging with tissue tagging in multiple short-axis and long-axis slices. Fully three-dimensional strain analyses were performed. All 6 end-systolic strain components were compared in regions 1 cm, 2 cm, 3 cm, and 4 cm below the valves, as well as in the anterior, posterior, and lateral left ventricular walls and the interventricular septum.


RESULTS
Circumferential shortening increased from before the Dor procedure to 6 weeks after repair in nearly every left ventricular region (13/16). The greatest regional change in circumferential shortening was found in the equatorial region or 2 cm below the base and in the posterior wall (from 9.0% to 18.4%; P < .0001). Longitudinal shortening increased 2 weeks after the Dor procedure but then returned near baseline by 6 weeks after the Dor procedure.


CONCLUSIONS
The Dor procedure significantly increases systolic circumferential shortening in nearly all noninfarcted left ventricular regions in sheep.
Zhang
Peng
P
Department of Surgery, University of California, San Francisco, Calif, USA.
Guccione
Julius M
JM
Nicholas
Susan I
SI
Walker
Joseph C
JC
Crawford
Philip C
PC
Shamal
Amin
A
Acevedo-Bolton
Gabriel
G
Guttman
Michael A
MA
Ozturk
Cengizhan
C
McVeigh
Elliot R
ER
Saloner
David A
DA
Wallace
Arthur W
AW
Ratcliffe
Mark B
MB
D000818:Animals; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006322:Heart Aneurysm / Q000601:surgery*; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D008026:Ligation; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology; D012756:Sheep; D013536:Suture Techniques; D016277:Ventricular Function, Left / Q000502:physiology*