title: Reconstructive surgery for an akinetic anterior ventricular wall in ischemic cardiomyopathy.
abstract: BACKGROUND
  The purpose of this prospective study is to analyze the postoperative outcome after only left ventricular reconstruction (LVR) versus LVR combined with coronary artery bypass grafting (CABG) and/or mitral valve (MV) procedure in ischemic cardiomyopathy (ICM) as a result of an akinetic anterior ventricular wall.
  
  
  RESULTS
  Nineteen patients underwent only LVR, and 37 underwent a concomitant LVR procedure. In both groups, New York Heart Association (NYHA) classification improved significantly from 3.5 +/- 0.6 to 2.2 +/- 0.5 (LVR group) and 3.4 +/- 0.7 to 2.5 +/- 0.5 (combined LVR group). Ejection fraction improved significantly from 25.1 +/- 3.2 to 35.3 +/- 4.5% in the LVR group and 28.1 +/- 2.2 to 37.6 +/- 5.5% in the combined LVR group. Cardiac index improved significantly from 1.8 +/- 0.6 to 2.3 +/- 0.5 l/min/m2 in the LVR group and 1.6 +/- 0.4 to 2.2 +/- 0.6 l/min/m2 in the combined LVR group. An additional concomitant procedure increased the mortality rate only slightly. The overall 1- and 5-year actuarial survival rates were 90% and 75% in the LVR group and 80% and 70% in the combined LVR group.
  
  
  CONCLUSIONS
  The LVR for akinetic ventricular wall shows very satisfactory early and long-term results. The LVR, with or without concomitant procedures, has considerable benefits for operative therapy.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart Center North-Rhine-Westphalia, Ruhr-University of Bochum, Germany.
authors.forename: Masataka
authors.initials: M
authors.lastname: Yoda
authors.forename: Gero
authors.initials: G
authors.lastname: Tenderich
authors.forename: Armin
authors.initials: A
authors.lastname: Zittermann
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schulte-Eistrup
authors.forename: Michaele
authors.initials: M
authors.lastname: Al-Deili
authors.forename: Reiner
authors.initials: R
authors.lastname: Körfer
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Minami
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D009202:Cardiomyopathies / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001026:Coronary Artery Bypass; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D009200:Myocardial Contraction; D017202:Myocardial Ischemia / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D020127:Recovery of Function; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*