Subscribe to RSS
DOI: 10.1055/s-0029-1191518
Cardiac magnetic resonance imaging to assess the impact of surgical ventricular reconstruction
Aims: The modified DOR procedure (SVR) is a recognized treatment option for the treatment of post infarct akinesia or dyskinesia. However, its effectiveness has never been truly quantified. Although cardiac magnetic resonance (CMR) is a powerful tool, there are no CMR-data in patients pre- and post SVR.
Objective: To assess cardiac volumes and geometric indices in patients before and after SVR.
Methods: 28 patients underwent SVR by endocircular patch plasty with or without a patch. Seven patients received mitral valve reconstruction for mitral regurgitation (MR) > II°. Nine had no MR. CMR was performed before and after surgery (before discharge).
Results: SVR caused a significant reduction in ventricular volumes (from 304±111 to 194±90.1ml, p<0.05). Ejection fraction increased from 24±8 to 35±12% (p<0.05). The Sphericity index (ratio of the internal diameters in short and long axis, SI) was closer to 1 after SVR, indicating the creation of ball shaped ventricle. The apical conicity index (ratio of internal diameters in apical and short axis, ACI) changed from 0.70±0.13 to 0.58±0.09. Mitral regurgitation in patients without mitral valve reconstruction improved in 4, worsenend in 2 and remained equal in 15 patients. All mitral valve reconstructions were competent. There was no correlation among volumes, SI, ACI, EF, MR and outcome.
Conclusions: SVR reduces ventricular volume and improves EF. However, we were not able to identify any other parameters with predictive power for determining patients prognosis. Studies with greater patient populations are required to fully address these relationships