The Long-Term Survival and Predictors of Heart Failure after Endoventricular Circular Patch Plasty

(Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan)

Yoshiyuki Nishimura Yasuhide Ookawa Hiroshi Baba
Syunsuke Fukaya Masakazu Aoki
Shinji Ogawa , Masashi Komeda
Endoventricular circular patch plasty(the Dor procedure)has been demonstrated to improve outcome in patients with ischemic cardiomyopathy. However, in some of them congestive heart failure(CHF)occurred during follow-up. This study examined the effects of the Dor procedure on the long-term survival and predictors of CHF after this procedure. Hemodynamic and clinical results were analyzed and predictors of CHF were examined. Postoperative ESVI in the CHF group was larger than that in the non-CHF group. The delayed MR rate was greater following the CHF group (82.4%) compared to the non-CHF group(19.2%). Despite mitral valve repair(N=8), 3 patients had delayed MR. All of them were greater than MR3. Hemodynamic and clinical results were improved by the Dor procedure. However, cardiac events were usually occurred during the follow-up. The predictor of CHF was delayed MR. Therefore, patients with preoperative MR should be treated. If preoperative MR is greater than 3, there will be MR recurrence cases after MVP only. Therefore, patients with preoperative MR(3 or 4)should be treated by alternative surgical procedures.
  Jpn. J. Cardiovasc. Surg. 38:1-6(2009)