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Original Articles: Adult Cardiac

Surgical Ventricular Restoration: Left Ventricular Shape Influence on Cardiac Function, Clinical Status, and Survival

^a Department of Critical Care Medicine, University of Florence, Florence, Italy
^b Department of Cardiac Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Donato Hospital, Milan, Italy
^c Silesian Medical University Katowice, Silesian Center for Heart Diseases, Zabrze, Poland

Accepted for publication October 16, 2008.

^_* Address correspondence to Dr Di Donato, Department of Cardiac Surgery, IRCCS, San Donato Hospital, Via Morandi 30, San Donato Milanese, 20097, Italy (Email: marad{at}tin.it).

Background: Myocardial infarction can result in a spectrum of left ventricular (LV) shape abnormalities. Surgical ventricular restoration (SVR) can be applied to any, but there are no data that relate its effectiveness to LV shape. Moreover, there is no consensus on the benefit of SVR in patients with a markedly dilated ventricle, without clear demarcation between scarred and normal tissue. This study describes postmyocardial infarction shape abnormalities and cardiac function, clinical status, and survival in patients undergoing SVR.

Methods: Echo studies of 178 patients were retrospectively reviewed. Three types of LV shape abnormalities were identified: type 1 (true aneurysm), type 2 (nonaneurysmal lesions defined as intermediate cardiomyopathy), and type 3 (ischemic dilated cardiomyopathy).

Results: SVR induced significant improvement in cardiac and clinical status in all patients, regardless LV shape types. Although not significant, mortality was higher in types 2 and 3.

Conclusions: Ischemic dilated cardiomyopathy and not just the true aneurysm can be successfully treated with SVR. Shape classification may be useful to improve patient selection and compare results from different institutions that are otherwise impossible to compare.

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