HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Vincent Dor Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dor, V. Search for Related Content PubMed PubMed Citation Articles by Dor, V. Related Collections Myocardial infarction

J Thorac Cardiovasc Surg 2004;128:17-20
© 2004 The American Association for Thoracic Surgery

Editorial

Left ventricular reconstruction: The aim and the reality after twenty years

^a Centre Cardio-Thoracique de Monaco, Monte Carlo, Monaco

Received for publication February 3, 2004; accepted for publication February 25, 2004.

^* Address for reprints: Vincent Dor, MD, Centre Cardio-Thoracique de Monaco, 11 bis, Avenue d'Ostende, Cedex Monte Carlo MC 98004, Monaco
vdor@ccm.mc

The first 300 words of the full text of this article appear below.

The Cleveland Clinic group's article in this issue, entitled "Neurohormonal Response to Left Ventricular Reconstruction Surgery in Ischemic Cardiomyopathy" and written by Schenk and collaborators,¹ is excellent. It should be read by cardiac surgeons and I hope by cardiologists, because its synthesis is a well-based confirmation that ischemic dilated failing ventricles can be improved by endoventricular circular reorganization. What a long way we've come since 1984, when all presentations of this technique to surgical and medical audiences were followed only by skeptical questions.

I appreciate the use by Schenk and collaborators¹ of the term "left ventricular reconstruction" (LVR), which avoids the confusion contained in the inappropriate "surgical remodeling" and is equivalent to the other names given later to the same procedure, such as "endoaneurysmorrhaphy" or "surgical ventricular restoration." The last word has, for the French, a poor political connotation.

This technique has been used since 1984, and the results of this serious, complete, precise, didactic article, coming from a renowned institution, allow us to assess whether the reality is in concordance with the aim. This technique was established to optimize the surgical procedure of extensive blind endocardiectomy proposed by Josephson and colleagues² to treat intractable recurrent ventricular tachycardias before the implantable defibrillator era. The goal was to improve the results, which were excellent for reducing lethal arrhythmias but extremely poor for augmenting left ventricular performance.

The aim of LVR was to use a circular patch sutured inside the ventricle on contractile myocardium to exclude all nonresectable asynergic areas (primarily septal), to reorganize the curvature of the distended wall, and to do all this without excessive volume reduction of the left ventricular cavity. I fully agree with four important points focused on by Schenk and collaborators¹; however, another point is questionable and yet another must be discussed.

Point one

The 15 patients . . . [Full Text of this Article]

This article has been cited by other articles:

				H. Suma, H. Tanabe, T. Uejima, S. Suzuki, T. Horii, and T. Isomura Selected ventriculoplasty for idiopathic dilated cardiomyopathy with advanced congestive heart failure: midterm results and risk analysis Eur. J. Cardiothorac. Surg., December 1, 2007; 32(6): 912 - 916. [Abstract] [Full Text] [PDF]

				G. D. Buckberg Invited commentary Ann. Thorac. Surg., April 1, 2007; 83(4): 1387 - 1388. [Full Text] [PDF]

				B. B. Carmichael, R. M. Setser, A. E. Stillman, M. L. Lieber, N. G. Smedira, P. M. McCarthy, R. C. Starling, J. B. Young, J. A. Weaver, A. G. Lawrence, et al. Effects of Surgical Ventricular Restoration on Left Ventricular Function: Dynamic MR Imaging Radiology, December 1, 2006; 241(3): 710 - 717. [Abstract] [Full Text] [PDF]

				G. Buckberg Editorial comment: Left ventricular reconstruction for dilated ischemic cardiomyopathy: biology, registry, randomization, and credibility Eur. J. Cardiothorac. Surg., November 1, 2006; 30(5): 759 - 761. [Full Text] [PDF]

				M. Kostelec, J. Covell, G. D. Buckberg, A. Sadeghi, J. I.E. Hoffman, and G. S. Kassab Myocardial protection in the failing heart: I. Effect of cardioplegia and the beating state under simulated left ventricular restoration J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 875 - 883. [Abstract] [Full Text] [PDF]

				H. Suma, T. Isomura, T. Horii, and F. Nomura Septal anterior ventricular exclusion procedure for idiopathic dilated cardiomyopathy. Ann. Thorac. Surg., October 1, 2006; 82(4): 1344 - 1348. [Abstract] [Full Text] [PDF]

				H. Suma, T. Horii, T. Isomura, G. Buckberg, and the RESTORE Group A new concept of ventricular restoration for nonischemic dilated cardiomyopathy Eur. J. Cardiothorac. Surg., April 1, 2006; 29(Suppl_1): S207 - S212. [Abstract] [Full Text] [PDF]

				T. Isomura, T. Horii, H. Suma, G. D. Buckberg, and the RESTORE Group Septal anterior ventricular exclusion operation (Pacopexy) for ischemic dilated cardiomyopathy: treat form not disease Eur. J. Cardiothorac. Surg., April 1, 2006; 29(Suppl_1): S245 - S250. [Abstract] [Full Text] [PDF]

				P. Ferrazzi, M. L.S. Matteucci, M. Merlo, A. Iacovoni, G. Rescigno, M. Bottai, P. Parrella, L. Lorini, M. Senni, and A. Gavazzi Surgical ventricular reverse remodeling in severe ischemic dilated cardiomyopathy: The relevance of the left ventricular equator as a prognostic factor J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 357 - 363. [Abstract] [Full Text] [PDF]

				J. L. Monro The next challenge--adapting to change Eur. J. Cardiothorac. Surg., December 1, 2004; 26(6): 1063 - 1072. [Full Text] [PDF]