Durability of epicardial ventricular restoration without ventriculotomy
OBJECTIVES We previously presented early results employing a technique designed for beating heart, ventricular volume reduction (surgical ventricular restoration, SVR) without ventriculotomy for patients with antero-septal scar and dilated ischaemic cardiomyopathy. Significant volume reduction and c...
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ftlithuaniansrc:oai:elaba:6155154 2023-05-15T18:15:17+02:00 Durability of epicardial ventricular restoration without ventriculotomy Wechsler, Andrew S. Sadowski, Jerzy Kapelak, Boguslaw Bartus, Krzystof Kalinauskas, Gintaras Ručinskas, Kęstutis Samalavičius, Robertas Annest, Lon 2013 http://vu.lvb.lt/VU:ELABAPDB6155154&prefLang=en_US eng eng info:eu-repo/semantics/altIdentifier/doi/10.1093/ejcts/ezt292 http://vu.lvb.lt/VU:ELABAPDB6155154&prefLang=en_US European journal of cardio-thoracic surgery, Oxford : Oxford University Press, 2013, vol. 44, iss. 3, p. e189-e192 ISSN 1010-7940 Heart failure Ischaemic cardiomyopathy Surgical ventricular reconstruction info:eu-repo/semantics/article 2013 ftlithuaniansrc https://doi.org/10.1093/ejcts/ezt292 2021-12-02T00:44:42Z OBJECTIVES We previously presented early results employing a technique designed for beating heart, ventricular volume reduction (surgical ventricular restoration, SVR) without ventriculotomy for patients with antero-septal scar and dilated ischaemic cardiomyopathy. Significant volume reduction and clinical improvement were achieved. We now report durability in the first 11 patients available for assessment at 6 and 12 months after operation. METHODS After the Ethics Committee approval, 31 symptomatic patients with left ventricular (LV) dilatation and antero-septal scars underwent operation. The scarred lateral LV wall was apposed to the septal scar with serial paired anchors placed through epicardial transmural catheters, excluding non-viable portions of the chamber. Patients were followed at 1, 3, 6 and 12 months postoperatively with echocardiograms. Data are presented for the first 11 patients for whom core lab echocardiographic data were available at 12 months of follow-up. RESULTS LV end-systolic index (LVESVI), percent decreases from baseline at 6 and 12 months were 36.2 ± 18.3 (P < 0.001) and 39.6 ± 14.8 (P < 0.001). LV end-diastolic volume index (LVEDVI) percent decreases from baseline at 6 and 12 months were 28.6 ± 18.8 (P < 0.001) at 6 months and 32.2 ± 14.9 (P < 0.005) at 12 months. All comparisons were by one-tailed t-tests using paired data. CONCLUSIONS These results demonstrate the persistence of volume reduction employing a technique designed to be used on beating hearts without ventriculotomy or cardiopulmonary bypass. The extent of volume reduction was consistent with results of conventional SVR in experienced centres. These early data validate the further development of technical iterations leading to a clinical study employing a closed chest endovascular platform. Article in Journal/Newspaper SCAR LSRC VL (Lithuanian Social Research Centre Virtual Library) European Journal of Cardio-Thoracic Surgery 44 3 e189 e192 |
institution |
Open Polar |
collection |
LSRC VL (Lithuanian Social Research Centre Virtual Library) |
op_collection_id |
ftlithuaniansrc |
language |
English |
topic |
Heart failure Ischaemic cardiomyopathy Surgical ventricular reconstruction |
spellingShingle |
Heart failure Ischaemic cardiomyopathy Surgical ventricular reconstruction Wechsler, Andrew S. Sadowski, Jerzy Kapelak, Boguslaw Bartus, Krzystof Kalinauskas, Gintaras Ručinskas, Kęstutis Samalavičius, Robertas Annest, Lon Durability of epicardial ventricular restoration without ventriculotomy |
topic_facet |
Heart failure Ischaemic cardiomyopathy Surgical ventricular reconstruction |
description |
OBJECTIVES We previously presented early results employing a technique designed for beating heart, ventricular volume reduction (surgical ventricular restoration, SVR) without ventriculotomy for patients with antero-septal scar and dilated ischaemic cardiomyopathy. Significant volume reduction and clinical improvement were achieved. We now report durability in the first 11 patients available for assessment at 6 and 12 months after operation. METHODS After the Ethics Committee approval, 31 symptomatic patients with left ventricular (LV) dilatation and antero-septal scars underwent operation. The scarred lateral LV wall was apposed to the septal scar with serial paired anchors placed through epicardial transmural catheters, excluding non-viable portions of the chamber. Patients were followed at 1, 3, 6 and 12 months postoperatively with echocardiograms. Data are presented for the first 11 patients for whom core lab echocardiographic data were available at 12 months of follow-up. RESULTS LV end-systolic index (LVESVI), percent decreases from baseline at 6 and 12 months were 36.2 ± 18.3 (P < 0.001) and 39.6 ± 14.8 (P < 0.001). LV end-diastolic volume index (LVEDVI) percent decreases from baseline at 6 and 12 months were 28.6 ± 18.8 (P < 0.001) at 6 months and 32.2 ± 14.9 (P < 0.005) at 12 months. All comparisons were by one-tailed t-tests using paired data. CONCLUSIONS These results demonstrate the persistence of volume reduction employing a technique designed to be used on beating hearts without ventriculotomy or cardiopulmonary bypass. The extent of volume reduction was consistent with results of conventional SVR in experienced centres. These early data validate the further development of technical iterations leading to a clinical study employing a closed chest endovascular platform. |
format |
Article in Journal/Newspaper |
author |
Wechsler, Andrew S. Sadowski, Jerzy Kapelak, Boguslaw Bartus, Krzystof Kalinauskas, Gintaras Ručinskas, Kęstutis Samalavičius, Robertas Annest, Lon |
author_facet |
Wechsler, Andrew S. Sadowski, Jerzy Kapelak, Boguslaw Bartus, Krzystof Kalinauskas, Gintaras Ručinskas, Kęstutis Samalavičius, Robertas Annest, Lon |
author_sort |
Wechsler, Andrew S. |
title |
Durability of epicardial ventricular restoration without ventriculotomy |
title_short |
Durability of epicardial ventricular restoration without ventriculotomy |
title_full |
Durability of epicardial ventricular restoration without ventriculotomy |
title_fullStr |
Durability of epicardial ventricular restoration without ventriculotomy |
title_full_unstemmed |
Durability of epicardial ventricular restoration without ventriculotomy |
title_sort |
durability of epicardial ventricular restoration without ventriculotomy |
publishDate |
2013 |
url |
http://vu.lvb.lt/VU:ELABAPDB6155154&prefLang=en_US |
genre |
SCAR |
genre_facet |
SCAR |
op_source |
European journal of cardio-thoracic surgery, Oxford : Oxford University Press, 2013, vol. 44, iss. 3, p. e189-e192 ISSN 1010-7940 |
op_relation |
info:eu-repo/semantics/altIdentifier/doi/10.1093/ejcts/ezt292 http://vu.lvb.lt/VU:ELABAPDB6155154&prefLang=en_US |
op_doi |
https://doi.org/10.1093/ejcts/ezt292 |
container_title |
European Journal of Cardio-Thoracic Surgery |
container_volume |
44 |
container_issue |
3 |
container_start_page |
e189 |
op_container_end_page |
e192 |
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1766188395504074752 |