The safety and effi cacy of epicardial ventricular restoration in patients with antero-septal scar and dilated ischemic cardiomyopathy
10.3969/j.issn.1004-8812.2018.01.007
- VernacularTitle:心外膜左心室重建术对前间壁瘢痕形成的缺血性心力衰竭患者的短期安全性及疗效评价
- Author:
Jian WANG
1
;
Guo-Sheng XIAO
;
Bin WANG
;
Zhi LIN
;
Hao YOU
;
Bo-Yuan HU
;
Qian YANG
;
Ke-Ke LAI
;
Mao-Long SU
;
Hong-Mei WEN
;
Zhi-Wei ZHAO
;
Yan WANG
Author Information
1. 厦门大学附属心血管病医院 心内科
- Keywords:
Epicardial ventricular restoration;
Ischemic heart failure;
Dilated ischemic cardiomyopathy;
Cardiac magnetic resonance
- From:
Chinese Journal of Interventional Cardiology
2018;26(1):31-35
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of epicardial ventricular restoration (EVR) using REVIVENT system in patients with antero-septal scar and dilated ischemic cardiomyopathy. Methods Ten ischemic heart patients with antero-septal scar underwent the operation. The scarred lateral left ventricular wall was apposed to the septal scar with serial paired anchors placed through epicardial transmural excluding the non-viable portions of the chamber. Left ventricular hemodynamic assessments as well as left ventricular ejection fraction, left ventricular end-systolic/diastolic volume (LVEDV/LVESV) and their indexes (LVEDVI/LVESVI) were measured by cardiac magnetic resonance (CMR). Results Ten ischemic heart failure patients with antero-septal scar, aged(55.2±13.9)years, received a hybrid epicardial ventricular restoration. Cardiac MR done at one a month after the procedure showed an elevation of LVEF from(27.8±4.6%)to(37.5±11.4)% (+35%, P<0.01). LVESV was significantly reduced from(149.9±61.6) ml to(109.9±58.0)ml (–26.7%, P<0.01), LVESVI was reduced from(84.8±36.7)ml/m2to(63.0±34.2) ml/m2(reduced by 25.7%, P<0.01); LVEDV was reduced from(203.0±64.0)ml to(167.9±58.2)ml (reduced by 17.3%, P<0.01), and LVESV was reduced from(114.5±37.8)ml/m2to(96.2±35.2)ml/m2(reduced by 16.0%, P<0.01). Cardiac output (CO) increased from(4.0±1.5)L/min to(4.8±1.2)L/min(increased by 20.0%, P=0.034) and cardiac index (CI) increased from(2.2±0.7)L/(min ? m2) to(2.7±0.7)L/(min ? m2) (increased by 22.4%, P=0.023). Conclusions Our preliminary experience on EVR using the REVIVENT system demonstrated signifi cant increase in LVEF, CO and CI, with decreases in LVEDV/LVESV at 1 month following the procedure. Its feasibility and safety need further evaluation in the future.
