Long-term results of left ventricular reconstructive surgery in patients with ischemic dilated cardiomyopathy: a multicenter study.
BACKGROUND
Left ventricular restoration (LVR) is increasingly used for treatment of chronic heart failure following myocardial infarction. The present multi-institutional retrospective study analyzed the long-term efficacy and limitations of LVR.


RESULTS
Seventy-two (58 males, mean age 62+/-10) patients who underwent LVR between January 1999 and June 2007 were included. Preoperatively, 50 (68.5%) were in New York Heart Association (NYHA) functional class III or IV. Mean left ventricular end-diastolic and end-systolic volume indexes were 145+/-43 ml/m(2) and 111+/-40 ml/m(2), respectively, and ejection fraction was 25+/-7.4%. Other concomitant operative procedures included coronary artery bypass grafting in 55 (76.4%), and mitral valve procedures in 38 (52.8%). Thirty-day mortality was 2.8%. Actuarial survival at 1, 3, and 5 years was 95.3%, 80.45 and 71.0% respectively. Mean ejection fraction significantly improved to 39+/-11%, and left ventricular volumes were significantly reduced in the early postoperative period. During a mean of 3.3+/-2.4 years of follow up, these improvements were still significant in the late period. Of the survivors, 90% were in NYHA functional class I or II.


CONCLUSIONS
LVR can be performed with a low operative mortality and provide satisfactory long-term survival by restoring the dilated left ventricle and improving systolic function.
Takeda
Koji
K
Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Matsumiya
Goro
G
Sakaguchi
Taichi
T
Matsue
Hajime
H
Masai
Takafumi
T
Otake
Shigeaki
S
Taniguchi
Kazuhiro
K
Sawa
Yoshiki
Y
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D002311:Cardiomyopathy, Dilated / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D015996:Survival Rate