title: Surgical anterior ventricular endocardial restoration performed with total arterial revascularization: serial 5-year follow-up.
abstract: OBJECTIVE
  We evaluated the changes in left ventricular (LV) function and volumes after surgical anterior ventricular endocardial restoration.
  
  
  METHODS
  A total of 63 patients who had undergone surgical anterior ventricular endocardial restoration and total arterial revascularization were included. Echocardiography and myocardial single photon emission computed tomography were performed to examine LV function and volumes preoperatively, early postoperatively, and annually thereafter to 5 years after surgery. Coronary angiography was performed at 5 years postoperatively.
  
  
  RESULTS
  Operative mortality was 7.9% (5 of 63). Echocardiograms performed before discharge demonstrated a significantly improved LV ejection fraction that was maintained at 5 years, significantly decreased early postoperative LV end-diastolic and end-systolic volume indexes that were slightly increased at 1 year and then maintained at 5 years, and early postoperative decrement of the stroke volume index that had disappeared at 1 year and had not reappeared by 5 years. Postoperative myocardial single photon emission computed tomography showed an LV ejection fraction that had gradually improved until 2 years and was maintained at 5 years, significantly decreased LV end-diastolic and end-systolic volume indexes that were maintained at 5 years, and a stroke volume index that was unchanged until 2 years and slightly increased at 3 to 4 years. The arterial graft patency rate in the left coronary territory was 95.7% (67 of 70) at 5 years. The 10-year overall survival and adverse event-free rate were 59.2% and 61.2%, respectively.
  
  
  CONCLUSIONS
  Improved LV ejection fraction and reduced volume indexes were maintained and the stroke volume index had not decreased at 5 years after the procedure. Preserved patency of the arterial grafts might have an important role in maintaining improved LV function.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Hwang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea.
authors.forename: Jun Sung
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, South Korea.
authors.forename: Kwang Ree
authors.initials: KR
authors.lastname: Cho
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea. Electronic address: kimkb@snu.ac.kr.
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Kim
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D004699:Endocardium / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013318:Stroke Volume; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014654:Vascular Patency; D016277:Ventricular Function, Left