title: Endoventricular patch plasty for dyskinetic anteroapical left ventricular aneurysm increases systolic circumferential shortening in sheep.
abstract: 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.
authors: Department of Surgery, University of California, San Francisco, Calif, USA.
authors: Peng
authors: P
authors: Zhang
authors: Julius M
authors: JM
authors: Guccione
authors: Susan I
authors: SI
authors: Nicholas
authors: Joseph C
authors: JC
authors: Walker
authors: Philip C
authors: PC
authors: Crawford
authors: Amin
authors: A
authors: Shamal
authors: Gabriel
authors: G
authors: Acevedo-Bolton
authors: Michael A
authors: MA
authors: Guttman
authors: Cengizhan
authors: C
authors: Ozturk
authors: Elliot R
authors: ER
authors: McVeigh
authors: David A
authors: DA
authors: Saloner
authors: Arthur W
authors: AW
authors: Wallace
authors: Mark B
authors: MB
authors: Ratcliffe
mesh_terms: 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*