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Surgical ventricular restoration

Lotte E Couperus, Victoria Delgado, Meindert Palmen, Marieke E van Vessem, Jerry Braun, Marta Fiocco, Laurens F Tops, Harriëtte F Verwey, Robert J M Klautz, Martin J Schalij, Saskia L M A Beeres
OBJECTIVE: Several clinical and left ventricular parameters have been associated with prognosis after surgical left ventricular restoration in patients with ischemic heart failure. The aim of this study was to determine the prognostic value of right ventricular function. METHODS: A total of 139 patients with ischemic heart failure (62 ± 10 years; 79% were male; left ventricular ejection fraction 27% ± 7%) underwent surgical left ventricular restoration. Biventricular function was assessed with echocardiography before surgery...
September 23, 2016: Journal of Thoracic and Cardiovascular Surgery
Mathew Bull, Mei Methawasin, Joshua Strom, Pooja Nair, Kirk Hutchinson, Henk Granzier
RATIONALE: Patients with heart failure with preserved ejection fraction (HFpEF) experience elevated filling pressures and reduced ventricular compliance. The splicing factor RNA-binding motif 20 (RBM20) regulates the contour length of titin's spring region and thereby determines the passive stiffness of cardiomyocytes. Inhibition of RBM20 leads to super compliant titin isoforms (N2BAsc) that reduce passive stiffness. OBJECTIVE: To determine the therapeutic potential of upregulating compliant titin isoforms in an HFpEF-like state in the mouse...
September 2, 2016: Circulation Research
James S Gammie, Peter Wilson, Krzysztof Bartus, Andrzej Gackowski, Judy Hung, Michael N D'Ambra, Piotr Kolsut, Gregory J Bittle, Piotr Szymanski, Jerzy Sadowski, Boguslaw Kapelak, Agata Bilewska, Mariusz Kusmierczyk, Mehrdad Ghoreishi
BACKGROUND: Degenerative mitral valve (MV) disease is a common cause of severe mitral regurgitation (MR) and accounts for the majority of MV operations. Conventional MV surgery requires cardiopulmonary bypass, aortic cross-clamping, cardioplegia, and a thoracotomy or sternotomy and, therefore, is associated with significant disability, risks, and unpredictable rates of MV repair. Transesophageal echocardiography-guided beating-heart MV repair with expanded polytetrafluoroethylene cordal insertion has the potential to significantly reduce surgical morbidity...
July 19, 2016: Circulation
Agnieszka A Książek, Katharyn J Mitchell, Laurent Morax, Colin C Schwarzwald, Simon P Hoerstrup, Benedikt Weber
BACKGROUND: Heterotopic heart transplantation (HHT) in rodent animal models represents an important technique enabling studies on organ transplantation immunology and pharmaceutical development. Recent investigations used nonworking HHT designs, with the left ventricle (LV) bypassed in the anastomosis system. In spite of their principal success, the lack of orthogonal ventricular filling leads to myocardial atrophy. However, when focusing on the cellular and molecular mechanisms involved in the in vivo remodeling of the myocardium or cell-based cardiovascular implants, a nonworking model is suboptimal as it lacks the native-analogous hemodynamic and metabolic situation...
July 20, 2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Eva Maria Delmo Walter, Mariano Francisco Javier, Frank Sander, Bernd Hartmann, Axel Ekkernkamp, Roland Hetzer
BACKGROUND: Primary cardiac tumors in infants and children are extremely rare; hence, there is very little literature available, and most knowledge is based on collections of case reports. This report is a comprehensive review of our 26-year experience with primary cardiac tumors in children with emphasis on surgical indications, strategies, and long-term outcome. METHODS: Between 1986 and 2012, 47 children (mean age 5.9 ± 2.4 months; range, 1 day to 17 years) underwent either subtotal or total resection of cardiac tumors (rhabdomyoma, 13; fibroma, 12; teratoma, 9; myxoma, 8; hemangioma, 2; rhabdomyosarcoma, 1; non-Hodgkin's lymphoma, 1; lymphangioma, 1)...
June 23, 2016: Annals of Thoracic Surgery
Carlos Alva-Espinosa
Corrected transposition of the great arteries is one of the most fascinating entities in congenital heart disease. The apparent corrected condition is only temporal. Over time, most patients develop systemic heart failure, even in the absence of associated lesions. With current imaging studies, precise visualization is achieved in each case though the treatment strategy remains unresolved. In asymptomatic patients or cases without associated lesions, focalized follow-up to assess systemic ventricular function and the degree of tricuspid valve regurgitation is important...
May 2016: Gaceta Médica de México
Yuli Y Kim, Emily Ruckdeschel
Residual right ventricular outflow tract and pulmonary valve disease is common in adults with repaired tetralogy of Fallot. Chronic severe pulmonary regurgitation as a result of surgical repair can lead to myriad complications including right ventricular dysfunction, decreased exercise tolerance, right heart failure and symptomatic arrhythmias. The aim of restoring pulmonary valve integrity is to preserve right ventricular size and function with the intent of mitigating the development of symptoms and poor long-term outcomes...
October 1, 2016: Heart: Official Journal of the British Cardiac Society
Lei-Lei Shen, Cheng Wang, Rong Wang, Cang-Song Xiao, Yang Wu, Yao Wang, Zhi-Yun Gong, Peng-Fei Guo, Hai-Zhi Zhao, Chang-Qing Gao
OBJECTIVE: To compare the mid- to long-term outcomes of patients receiving isolated coronary artery bypass grafting (CABG) versus surgical ventricular restoration (SVR) plus CABG for left ventricular aneurysms. METHODS: The clinical data were retrospectively analyzed in 205 patients with left ventricular aneurysms admitted to our hospital between January, 1997 and December, 2012, including 115 patients receiving SVR plus CABG and 90 undergoing isolated CABG. By matching preoperative echocardiographic parameters including aneurysm size, left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI) and EuroSCORE risk factors, 32 patients receiving SVR plus CABG and another 32 with isolated CABG were enrolled in this study...
May 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Francesco Nappi, Mario Lusini, Cristiano Spadaccio, Antonio Nenna, Elvio Covino, Christophe Acar, Massimo Chello
BACKGROUND: Guidelines recommend surgery for patients with severe ischemic mitral regurgitation (MR). Nonrandomized studies suggest that subvalvular repair is associated with longer survival, but randomized studies are lacking. OBJECTIVES: This study sought to investigate the benefit of papillary muscle surgery on long-term clinical outcomes of patients with ischemic MR. METHODS: Ninety-six patients with severe ischemic MR were randomized to either undersizing restrictive mitral annuloplasty (RA) or papillary muscle approximation with undersizing restrictive mitral annuloplasty (PMA) associated with complete surgical myocardial revascularization...
May 24, 2016: Journal of the American College of Cardiology
Eldaniz Aliyev, Ahmet Dolapoglu, Ilimbek Beketaev, Cagatay Engin, Tahir Yagdi, Anil Ziya Apaydin, Mustafa Ozbaran, Munevver Yuksel
BACKGROUND: Left ventricular aneurysm is a serious mechanical complication of myocardial infarction and has an incidence of 10-35% after myocardial infarction. Ventricular aneurysm in patients with angina, heart failure, and ventricular arrhythmia should be surgically treated. Endoaneurysmorrhaphy is one of the repair techniques that results in better left ventricular geometry and function. After this surgical procedure the ventriculotomy is repaired either with Teflon felt strips or by direct suture of the epicardium...
2016: Heart Surgery Forum
María Elena Arnáiz-García, José María González-Santos, Alberto Iscar-Galán, José María Fernández García-Hierro, María José Dalmau-Sorlí, Javier López-Rodríguez
Progressive dyspnea after myocardial infarction can suggests the presence of left ventricular (LV) dysfunction or a left ventricular aneurysm (LVA). Surgical treatment of LVA aims to reduce its volume and to restore the ventricle. Recurrence of LVA after previous repair is extremely rare and the occurrence of concomitant postoperative true and false aneurysms is extraordinary. Surgery is usually challenging because of LV dysfunction and cardiac adherences in reoperations. We describe the simultaneous occurrence in a patient of a recurrent true and false LVA after surgical repair of a postinfarction LVA...
May 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Gerald D Buckberg
No abstract text is available yet for this article.
April 22, 2016: European Journal of Cardio-thoracic Surgery
Weina Zhou, Xiangcheng Wang, Yulin He, Yongzhen Nie, Guojian Zhang, Cheng Wang, Chunmei Wang, Xuemei Wang
OBJECTIVE: Using a swine model of acute myocardial ischemia, we sought to validate N-(11)C-methyl-dopamine ((11)C-MDA) as an agent capable of imaging cardiac sympathetic nerve injury. METHODS: Acute myocardial ischemia was surgically generated in Chinese minipigs. ECG and serum enzyme levels were used to detect the presence of myocardial ischemia. Paired (11)C-MDA PET and (13)N-ammonia PET scans were performed at baseline, 1 day, and 1, 3, and 6 months after surgery to relate cardiac sympathetic nerve injury to blood perfusion...
2016: BioMed Research International
Yazhini Ravi, Shelley Bansal, Paola C Rosas, Ernest L Mazzaferri, Chittoor B Sai-Sudhakar
Chronic heart failure is the leading cause of death in the world. With newer therapies, the burden of this disease has decreased; however, a significant number of patients remain refractive to existing therapies. Myocardial infarction often leads to ventricular remodeling and eventually contributes to heart failure. The Parachute™ (Cardiokinetix, Menlo Park, CA) is the first device designed for percutaneous ventricular restoration therapy, which reduces left ventricular volume and minimizes the risk of open surgical procedures...
April 2016: Proceedings of the Baylor University Medical Center
Gabor G Toth, Marc Vanderheyden, Jozef Bartunek
While heart failure is one of the leading causes of mortality and morbidity, our tools to provide ultimate treatment solutions are still limited. Recent developments in new devices are designed to fill this therapeutic gap. The scope of this review is to focus on two particular targets, namely (1) left ventricular geometric restoration and (2) atrial depressurization. (1) Reduction of the wall stress by shrinking the ventricular cavity has been traditionally attempted surgically. Recently, the Parachute device (CardioKinetix Inc...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Piergiorgio Tozzi, Roger Hullin
Patients with chronic heart failure who are not eligible for heart transplant and whose life expectancy depends mainly on the heart disease may benefit from mechanical circulatory support. Mechanical circulatory support restores adequate cardiac output and organ perfusion and eventually improves patients' clinical condition, quality of life and life expectancy. This treatment is called destination therapy (DT) and we estimate that in Switzerland more than 120 patients per year could benefit from it. In the last 10 years, design of the devices, implantation techniques and prognoses have changed dramatically...
2016: Swiss Medical Weekly
Jianhua Xiong, Jian Hou
Cardiovascular disease plagues the whole world due to intensive lifestyle changes. Heart regeneration holds great promise for repairing and restoring cardiomyocytes lost due to injury and disease. In contrast to the robust cardiac regeneration of certain lower vertebrates, adult mammalian hearts typically show minimal capacity for heart regeneration and repair. However, recent studies have sparked considerable scientific interest with the finding that, between postnatal day 1 to 7 (P1 to P7), the neonatal mouse heart retains significant regenerative potential after apical resection (i...
2016: Journal of Visualized Experiments: JoVE
Serenella Castelvecchio, Alessandro Parolari, Andrea Garatti, Piervincenzo Gagliardotto, Eugenio Mossuto, Alberto Canziani, Lorenzo Menicanti
OBJECTIVES: To assess the early and mid-term outcomes and related predictors in a consecutive series of patients who underwent surgical ventricular restoration (SVR) combined with additional mitral valve (MV) repair. METHODS: From January 2001 to October 2014, 626 patients underwent SVR; of these, 175 (28%, median age 65) had an additional MV repair. Anterior, inferior or diffuse remodelling was present in 124 (71%), 41 (23%) and 10 (6%) patients, respectively. The median ejection fraction was 30%, whereas mitral regurgitation grade was 3...
April 2016: European Journal of Cardio-thoracic Surgery
Xiao Li, Si-Meng Wang, Christian Schreiber, Wei Cheng, Ke Lin, Jia-Yu Sun, Dan Yang, Shu-Hua Luo, Qi An, Yu-Cheng Chen
BACKGROUND: Cone reconstruction is a novel surgical procedure for tricuspid valve repair in Ebstein anomaly. This study examined the effect of cone reconstruction on right ventricle (RV) geometry, function, and synchronization. METHODS: Twenty-one patients (4-49 year-old) underwent cone reconstruction were enrolled, and matched with healthy individuals. Pre-operative and follow-up echocardiography was performed along with cardiac magnetic resonance (CMR) imaging in 18 patients...
March 1, 2016: International Journal of Cardiology
Mark G Davies, Hosam F El-Sayed
Acute pulmonary embolism (PE) continues to carry a high mortality if not recognized early and treated aggressively. Rapid recognition and diagnosis remains the mainstay of all efforts. Risk stratification early is paramount to guide therapy and achieve successful outcomes. Pulmonary emboli can generally be classified as massive, submassive, or stable. Fibrinolysis and/or surgical embolectomy are recommended for the treatment of the patient with massive PE to rescue the patient and restore hemodynamic stability...
February 2016: Annals of Vascular Surgery
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