Our study group consists of 12 patients which were operated on with the diagnossis of left ventricular aneurysm. Endoventricular circular patch plasty or septoexclusion antonio maria calafiore m. Figure 2 from postinfarction ventricular septal perforation. Endoventricular circular patch plasty for endstage valvular. Ventricular energetics in endoventricular circular patch plasty for dyskinetic anterior left ventricular aneurysm. Between october 1997 and may 2001, 22 patients 19 males and 3 females. A 17year experience vincent dar, marisa di donato, michel sabatier, franfoise montiglio, filippo civaia, and the restore group the first experience with endoventricular circular patch plasty evcpp was reported in 1984 as a surgical method to rebuild left ventricular lv geometry made more. In this procedure, the lv volume is reduced and the lv chamber is reconstructed using an endoventricular circular patch. Journal of the american college of cardiology, 1997, 27, 1569 1575.
Surgical management of left ventricular aneurysms by. Left ventricular reconstruction by endoventricular circular. Endoventricular circular patch plasty or septoexclusion. It is also known as endoventricular circular patch plasty evcpp. Modified endoventricular circular plasty dor procedure. The endoventricular circular patch plasty dor procedure applies to patients with a left ventricular dysfunction due to an ischemic dilated ventricle. Although the early result of endoventricular circular patch plasty evcpp has been reported, few are seen about the longterm results. Ventricular energetics in endoventricular circular patch. Jan 26, 2015 endoventricular circular patch plasty dor operation. This video demonstrates two cases of left ventricular circular patch plasty dor operation for large. Postinfarction ventricular septal perforation repair with. All seven patients had anterior left ventricular aneurysms following old myocardial infarction. Ismics 8th annual meeting program midterm results after. Endoventricular circular patch plasty repair dor, or modified dor, procedure to credit vincent dor, md, who authored many articles on the procedure he began performing in the early 1980s surgical ventricular restoration.
The endoventricular circular patch plasty dor procedure. This study evaluates clinical and hemodynamic results of endoventricular circular patch plasty in patients with either large akinetic scar n 51 or large dyskinetic scar n 49 and depressed left ventricular function ejection fraction endoventricular circular patch plasty technique. Linear endoventricular patch plasty resulted in a decrease in enddiastolic volume edv of 40. Preoperative parameters predicting the postoperative. This technique restores circular ventricular architecture by excluding the septal scar and, by means of the laplace relationship, reducing the cavity to restore wall tension toward normal and thereby improve hemodynamic status. The mean age of the patients at the time of surgery was 63 years old. Left ventricular aneurysm lva is a serious complication of myocardial infarction and reduces the chances of survival. He has improved much after the operation and is now in new york heart association nyha functional class ii. Between 1996 and 2001,23 consecutive patients with left ventricular aneurysm andor ischemic cardiomyopathy after myocardial infarction who underwent dor operation were. The repair involves endoventricular circular patch plasty and application of gelatinresorcinolformaldehyde biological glue in the space between a teflon felt patch on the infarcted septum and a bovine pericardial patch in the left ventricular cavity.
Early results after surgical treatment of left ventricular. Biventricular pacing with coronary bypass and dors. Endoventricular circular patch plasty dor procedure has been reported to be a surgical method that applies to patients with a left ventricular lv dysfunction after a myocardial infarction for either akinesia or dyskinesia. Tanoue y, ando h, fukumura f, umesue m, uchida t, taniguchi k, et al.
We used the qgs method to evaluate regional wall function in the early and the midterm period after endoventricular circular patch plasty evcpp. Dor procedure definition of dor procedure by medical dictionary. We studied left ventricular lv function in the early and midterm periods after evcpp with electrocardiographicgated single photon emission computed tomography gated spect. The various drawbacks related to this technique can be offset by a modification based on a mathematical hypothesis, which should result in a more physiological ventricular geometry, with consequent late reverse remodeling and. Relation to surgical outcome in patients undergoing endoventricular circular patch plasty repair. Dor operation endoventricular circular patch plasty. In 1958, cooley resected a left ventricular aneurysm lva while using cardiopulmonary bypass to sustain the systemic circulation, thereby ushering in the modern era of surgery for left ventricular aneurysms. We report hemodynamic and clinical results of our series of endoventricular circular patch plasty dor operation and consider some advantages of this procedure for patients with ischemic cardiomyopathy. Dor operation endoventricular circular patch plasty video. Between july 1987 and march 1996, 562 patients underwent endoventricular patch plasty repair and coronary grafting for postinfarction lv aneurysm at the cardiothoracique center of monaco.
Left ventricular reconstruction by endoventricular circular patch plasty repair. The repair involves endoventricular circular patch plasty and application of gelatinresorcinolformaldehyde biological glue in the space between a teflon felt patch on the infarcted septum and a bovine pericardial patch. We investigated the preoperative predictors and defined the. The dor procedure is a medical technique used as part of heart surgery and originally introduced by the french cardiac surgeon vincent dor b. Endoventricular circular patch plasty dor operation.
Dilated cardiomyopathy, endoventricular circular patch plasty. Initial valve surgery was an aortic valve replacement avr with mechanical tilting disc valve for rheumatic aortic. We describe a technique for repairing the ventricular septal perforation 10 days post acute anteroseptal myocardial infarction using the modified infarction exclusion method. The procedure itself is a viable method of restoring a dilated left ventricle to its normal eliptical geometry. Preoperative parameters predicting the postoperative course of endoventricular circular patch plasty keiichiro kondo, md, yoshihide sawada, md, and shinjiro sasaki, md, phd it is necessary that preoperative factors predicting the postoperative course be easily and precisely documented. Endoventricular circular patch plasty is considered in patients with ischemic cardiomyopathy, large anterior wall akinetic or dyskinetic segments, and a spherically dilated lv. Didonato m, sabatier m, dor v, toso a, maioli m, fantini f. Efficacy of endoventricular circular patch plasty springerlink. Reverse remodeling after endoventricular circular patch. A 66yearold male patient was admitted to our hospital for treatment of nyha class iv heart failure. The repair involves endoventricular circular patch plasty and application of gelatinresorcinolformaldehyde biological glue in the space between a teflon felt patch on the infarcted septum and a bovine. Seven patients with ischemic cardiomyopathy who underwent elective endoventricular circular patch plasty evcpp were included in this study. This allows to exclude all asynergic areas of the left ventricular wall and reshape the remaining wall. The consequence is dilated ischemic cardiomyopathy.
Many believe that dyskinesia is the only predictor of favorable surgical outcome after large myocardial infarction and that akinetic scars do not recover well in patients with globally depressed ventricular function. In 1984, dor used endoventricular circular patch plasty the dor procedure to restore lv size and shape by excluding the infarcted anterior lv wall and the interventricular septum in patients with ischemic cardiomyopathy and either an akinetic or dyskinetic anterior wall. In 1985, dor introduced evcpp as a viable method for restoring a dilated left ventricle lv to its normal, elliptical geometry. We analyze the efficacy of two techniques, linear vs. Surgical management of left ventricular aneurysms by the. Left ventricular reconstructive surgery modified dor procedure. Left ventricular volume and function after endoventricular. Sixtyone patients who underwent the dor procedure for ischemic dyskineticakinetic left ventricle were studied with mean followup of 26. Left ventricular lv pump function improvement is difficult to predict after. We performed the dacron patch fixation to the left. Endoventricular circular patch plasty or septoexclusion, journal of cardiac surgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Preoperative parameters predicting the postoperative article.
The geometric reconstruction of the left ventricle with intraventricular patch dors operation is also performed in ischemic. Its use in a patient resulted in an almost normal shaped continue reading. Citeseerx document details isaac councill, lee giles, pradeep teregowda. In anterior infarction, the free lv wall and septum are scarred and become dyskinetic or akinetic. Dor v, saab m, coste p, kornaszewska m, montiglio i. The technique of surgical ventricular restoration employed in the stich trial was circular endoventricular patch plasty. Department of cardiology and cardiac surgery, university g. We performed the dacron patch fixation to the left ventricle with. Controversy still exists regarding the optimal surgical technique for lva repair. The aim of this our study is to indicate that the endoventricular circular patch plasty evcpp which is recommended by dor can be performed with a simpler and more hemostatic suture technique. Left ventricular lv pump function improvement is difficult to predict after aneurysmectomy, for either.
Its use in a patient resulted in an almost normal shaped. Endoventricular circular patch plasty dor operation ctsnet. This video demonstrates two cases of left ventricular circular patch plasty dor operation for large akinetic postinfarction aneurysms. Modified endoventricular circular plasty dor procedure ctsnet. This study evaluates clinical and hemodynamic results of endoventricular circular patch plasty in patients with either large akinetic scar n 51 or. Google scholar see all references and we first employed the technique of endoventricular circular patch plasty evcpp in 1984.
Application of circular patch plasty dor procedure or. Between 1996 and 2001,23 consecutive patients with left ventricular aneurysm andor ischemic cardiomyopathy after. Endoventricular circular patch plasty for endstage. Few modifications in his technique of simple resection and. We investigated the preoperative predictors and defined the indications of endoventricular circular patch plasty evcpp in patients with ischemic cardiomyopathy icm. Dor operation endoventricular circular patch plasty youtube. Standard technique of evcpp the surgical procedure is described in figure 1, and routine transesophageal echocardiographic.
Between april 1994 and april 2004, 31 patients underwent the evcpp to repair an anterior left ventricular aneurysm. A 17year experience vincent dar, marisa di donato, michel sabatier, franfoise montiglio, filippo civaia, and the restore group the first experience with endoventricular circular patch plasty evcpp was reported in 1984 as a surgical method to rebuild left ventricular lv geometry made more spheric after. Nov 21, 2012 left ventricular aneurysm lva is a serious complication of myocardial infarction and reduces the chances of survival. The surgical technique of linear endoventricular patch plasty. Dor procedure definition of dor procedure by medical. Dor procedure or the endoventricular circular patch plasty evccp, is an operation, introduced by vincent dor, in 1985. Endoventricular circular patch plasty or septoexclusion septoexclusion is a technique described by guilmet in the mid 1980s. Endoventricular circular patch plasty dor operation vumedi. This retrospective study attempted to relate surgical outcome with the extent and type of preoperative wall motion asynergy in patients with postinfarction myocardial scar who underwent endoventricular circular patch plasty repair and associated coronary grafting. Dors endoventricular circular patch plasty was then performed. Left ventricular reconstruction by endoventricular. Left ventricular reconstructive surgery modified dor. Its use in a patient resulted in an almost normal shaped interventricular septum and left.
Early and midterm results of endoventricular circular patch plasty dor procedure concomitant with total arterial revascularization were studied. Both morphology and hemodynamic of left ventricle, are improved. In the present study, we analyzed left ventricular energetics in patients who underwent the dor procedure. The patient underwent surgery where left ventricular volume reduction using endoventricular circular patch plasty evcpp and mitral valve replacement mvr were performed. Jan 25, 2016 dor operation endoventricular circular patch plasty.
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