Preserving autologous heart operation for ischemic cardiomyopathy
Hoshino, J.; Fukada, Y.; Hirota, M.; Katahira, S.; Gyoten, T.; Isomura, T.
Kyobu Geka. Japanese Journal of Thoracic Surgery 64(11): 981-984
2011
ISSN/ISBN: 0021-5252 PMID: 22111341 Document Number: 648411
We report our surgical procedure (preserving autologous heart operation) for the patients with ischemic cardiomyopathy (ICM), and the results. Since May 2000, 212 patients received surgical procedure for ten years. We performed complete coronary artery bypass grafting (CABG), mitral surgery (plasty or replacement) for the patients with more than mild mitral regurgitation. We performed papirally muscle plication since 2005, and we performed 2nd chordal cutting since 2008, for the patients with mitral regurgitation (MR) due to severe mitral tethering. The surgical left ventricular reconstruction (SVR) was performed for the patients with dilated left ventricular. We use speckle tracking echocardiography to decide the type of the procedure of surgical left ventricular reconstruction since 2008. Hospital death was 8.0%, and late death was 9.9%. Almost of the cause of death was congestive heart failure and ventricular arrhythmia. Five years survival was 78%, 10 years survival was 73%. The non transplant surgery for the patient with ICM was effective with the combination of CABG, mitral valve plasty (MVP) or mitral valve replacement (MVR), SVR. The size of left ventricle (LV) after SVR seemed to be a factor for late outcome of the surgery.