JTCS KCI
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lunkenheimer, P.P.
Right arrow Articles by Anderson, R.H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lunkenheimer, P.P.
Right arrow Articles by Anderson, R.H.
Related Collections
Right arrow Cardiac - physiology
Right arrow Cardiac - other
Right arrow Congestive Heart Failure

J Thorac Cardiovasc Surg 2003;126:592-596
© 2003 The American Association for Thoracic Surgery

Brief communication

Surgical reduction of ventricular radius by aspirated plication of the myocardial wall: an experimental study

P.P. Lunkenheimer, MDa,*, K. Redmann, Dr rer medica, J.C. Florek, cand meda, H.H. Scheld, MDa, A. Hoffmeier, MDa, C.W. Cryer, PhDb, R.V. Batista, MDc, J.J. Stanton, MDd, J.D. Frota Filho, MDe, R.H. Anderson, MDf

a Klinik und Poliklinik für Thorax, Herz, und Gefässchirurgie,, University Münster, Münster, Germany
b Institut für Numerische Mathematik, University Münster, Münster, Germany
c Foundation R. V. Batista, Curitiba, Brazil
d Department of Cardiothoracic Surgery, Pretoria Academic Hospital, Pretoria, South Africa
e Hospital Sao Francisco, Cirugia Cardiovascular, Porto Alegre, Brazil
f Cardiac Unit, Institute of Child Health, University College London, London, United Kingdom

Received for publication August 14, 2002; accepted for publication January 22, 2003.

* Address for reprints: P. P. Lunkenheimer, MD, Experimentelle Thorax-, Herz- und Gefässchirurgie, Universitätskliniken Münster, Domagkstrasse 11, 48129 Münster, Germany
redmann@uni-muenster.de

Key Words: 17 • 18 • 22

The first 300 words of the full text of this article appear below.

At its introduction, partial left ventriculectomy was seen as a promising option.1 As initially used, its main drawback was its unpredictable effect on cardiac function. The size, shape, and location of the segment to be resected were at the discretion of the surgeon. Once the segment had been resected, any disadvantageous results were irreversible. Resection, and subsequent coaptation of the incision, often compromised coronary perfusion.2 Experience showed that insufficient narrowing of the ventricular base could cause late postoperative mitral valvular incompetence.3 Right ventricular function was also impaired by extensive resections from the left ventricle.4 A further reported complication is sudden death from ventricular fibrillation, which reportedly occurred within 6 months of the intervention.5

Encouraging initial clinical results1,6-8 nonetheless have shown that the basic concept of partial left ventriculectomy is sound, at least when conceived as a bridging procedure. To validate the technique and improve its results, we have devised an off-pump strategy that permits reduction of ventricular radius by plication of a chosen segment of ventricular wall. By using aspirator cups, we avoid an open procedure. The technique permits initial sequestration in trial fashion, allowing us to assess ventricular function. Only if it is judged satisfactory do we then perform the definitive ventricular plication. Our new technique of sutured splinting for the definitive plication preserves the coronary vasculature.

Methods

In 8 female pigs weighing 80 ± 7.6 kg, with hearts of normal size and function, we performed left lateral thoracotomies under deep ketamine-halothane anesthesia. The pericardium was split from the base to the apex, and 100 mg lidocaine (Xylocaine) were repetitively injected into the pericardial cradle. An aspirator cup, designed to fit the size and shape of the area to be sequestered, was placed on the left ventricular free wall (Figure 1). Suction was applied, sequestering the segment by . . . [Full Text of this Article]




This article has been cited by other articles:


Home page
 Eur J Cardiothorac SurgHome page
S. Christiansen and R. Autschbach
Doxorubicin in experimental and clinical heart failure
Eur J Cardiothorac Surg, October 1, 2006; 30(4): 611 - 616.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2003 by The American Association for Thoracic Surgery.