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J Thorac Cardiovasc Surg 2002;124:395-397
© 2002 The American Association for Thoracic Surgery


Brief Communications

Overlapping cardiac volume reduction operation

Yoshiro Matsui, MDa, Yasuhisa Fukada, MDa, Yukio Suto, MDb, Hidetoshi Yamauchi, MDb, Bin Luo, MDb, Masatoshi Miyama, MDb, Shigeyuki Sasaki, MDc, Tatsuzo Tanabe, MDa, Keishu Yasuda, MDb Sapporo and Ishikari-Tobetsu, Japan

From the Department of Cardiovascular Surgery, NTT East Corporation Sapporo Hospital,a Sapporo, the Department of Cardiovascular Surgery, Hokkaido University School of Medicine,b Sapporo, and the Division of Medical Sciences, Health Science University of Hokkaido,c Ishikari-Tobetsu, Japan.

Received for publication Dec 12, 2001. Accepted for publication Feb 5, 2001. Address for reprints: Yoshiro Matsui, MD, NTT East Corporation Sapporo Hospital, Department of Cardiovascular Surgery, S1W15 Chu-ku, Sapporo, Japan (E-mail: yoshirou_matsui@hokkaido.east.ntt.co.jp).

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Dr Matsui

 
Partial left ventriculectomy (PLV) has been introduced to treat end-stage cardiomyopathy but has not achieved a favorable outcome. We thought it important to preserve cardiac muscle possessing the potential power source of the left ventricle and to avoid resection of the left circumflex coronary artery. From this viewpoint, we developed a new operative procedure of left ventricular (LV) volume reduction without any resection of cardiac muscle and have confirmed its beneficial effect in a canine model. This is the first clinical report of this new procedure.

Clinical summary

A 62-year-old man with dilated cardiomyopathy (DCM) was referred to our institution in August 2001. Since 1995, he has been treated with medication, including ß-blockers, for DCM with mild mitral and aortic regurgitation confirmed by endocardial biopsy. However, he had orthopnea (New York Heart Association class III) in May 2001, when echocardiography demonstrated an ejection fraction (EF) of 23% with severe mitral and moderate aortic and tricuspid regurgitation. In July 2001, he required direct-current shock to be resuscitated from an arrhythmia. Preoperative catheter laboratory study showed mean . . . [Full Text of this Article]




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