Long-Term Results of Hybrid Left Ventricular Reconstruction in the Treatment of Ischemic Cardiomyopathy

• Published in: Journal of cardiovascular translational research Vol. 14; no. 6; pp. 1043 - 1050
• Main Authors: Naar, Jan, Skalský, Ivo, Krűger, Andreas, Málek, Filip, Van Bladel, Kevin, Annest, Lon S., Moučka, Petr, Mráz, Tomáš, Reddy, Vivek Y., Neužil, Petr
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2021
• Subjects: Biomedical Engineering and Bioengineering; Biomedicine; Cardiac Surgical Procedures - methods; Cardiology; Cardiomyopathies - diagnostic imaging; Cardiomyopathies - surgery; Female; Human Genetics; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Ischemia - diagnostic imaging; Myocardial Ischemia - surgery; Original; Original Article; Prospective Studies; Reconstructive Surgical Procedures - methods; Stroke Volume; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - surgery; Walk Test; Left ventricular reconstruction; Hybrid approach; Left ventricular aneurysm; Ischemic cardiomyopathy
• ISSN: 1937-5387; 1937-5395; 1937-5395
• DOI: 10.1007/s12265-021-10133-9

The evidence supporting surgical aneurysmectomy in ischemic heart failure is inconsistent. The aim of the study was to describe long-term effect of minimally invasive hybrid transcatheter and minithoracotomy left ventricular (LV) reconstruction in patients with ischemic cardiomyopathy. Twenty-three subjects with transmural anterior wall scarring, LV ejection fraction 15–45%, and New York Heart Association class ≥ II were intervened using Revivent TC anchoring system. LV end-systolic volume index was reduced from 73.2 ± 27 ml at baseline to 51.5 ± 22 ml after 6 months ( p < 0.001), 49.9 ± 20 ml after 2 years ( p < 0.001), and 56.1 ± 16 ml after 5 years ( p = 0.047). NYHA class improved significantly at 5 years compared to baseline. Six-min walk test distance increased at 2 years compared to the 6-month visit. Hybrid LV reconstruction using the anchoring system provides significant and durable LV volume reduction during 5-year follow-up in preselected patients with ischemic heart failure. Graphical abstract Legend : Hybrid left ventricular reconstruction using the anchoring system provides significant and durable LV volume reduction throughout 5-year follow-up in preselected patients with ischemic heart failure.