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J Thorac Cardiovasc Surg 2007;134:1070-1072
© 2007 The American Association for Thoracic Surgery

Brief Communication

An innovative technique for the relief of right ventricular trabecular cavity obliteration in endomyocardial fibrosis

Ana Olga Mocumbi, MDa, Daniel Sidi, MD, PhDb, Pascal Vouhe, MD, PhDa, Magdi Yacoub, FRSa,*

a Imperial College, London, United Kingdom, and Instituto do Coração, Maputo, Mozambique
b Hopital Necker Enfants Malades, Paris, France, and Instituto do Coração, Maputo, Mozambique.

Received for publication April 2, 2007; accepted for publication April 20, 2007.

* Address for reprints: Magdi Yacoub, FRS, Heart Science Centre–Harefield, Middlesex UB9 6JH, United Kingdom. (Email: m.yacoub@imperial.ac.uk).

The first 20% of the full text of this article appears below.

Endomyocardial fibrosis (EMF) mainly affects persons from Africa, South America, and Asia.1Go The pathogenesis of this condition remains unknown. In advanced forms, EMF produces marked disability and carries a poor prognosis. Although there is consensus about the potential value of surgical intervention in symptomatic patients, there is still debate regarding the exact timing and the surgical technique to be used.2,3Go

EMF is characterized by endocardial fibrosis affecting the inflow tract and the apex of 1 or both ventricles, commonly involving the atrioventricular valves. The right ventricle is affected in most cases.4Go In severe forms, marked reduction of ventricular volume is thought to be due to the presence of a plug of fibrous tissue involving both the trabecular part and the apex.5Go

We here describe a new mechanism for apical obliteration of the right ventricle in EMF. The concept was used to evolve and apply a new surgical technique to increase ventricular volume, improve contractile function by releasing the myocardium and making use of viable myocardium in the obliterated area, . . . [Full Text of this Article]




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