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A Journal on Surgery

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Chirurgia 2012 August;25(4):243-9


language: English

Review of 6 cases of modified left ventricular restoration: endoventricular spiral placation

Hiraoka A., Kuinose M., Chikazawa G., Totsugawa T., Katayama K., Yoshitaka H.

Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, Okayama, Japan


Although surgical reconstruction of the left ventricle (LV) after anterior myocardial infarction has evolved to restore ventricular shape and volume, it is still challenging. We have reported a modified technique of surgical ventricular restoration after anterior myocardial infarction, entitled Endoventricular Spiral Plication (ESP). We reviewed 6 cases employing the ESP technique, and evaluated the outcomes. Between May 2010 and February 2011, 6 patients underwent ESP technique at the Sakakibara Heart Institute of Okayama. All the patients had an old anterior myocardial infarction. This technique is simple to perform because it uses only double spiral stitches instead of a Fontan stitch and patch materials. There were significant improvements in LV ejection fraction (LVEF), LV end-diastolic volume and LV end-systolic volume (23.7 ± 8.0% pre versus 33.3 ± 7.4% post; P = 0.079, 150.3 ± 22.7 ml/m2 pre versus 99.8 ± 19.3 ml/m2 post; P < 0.01, and 115.4 ± 21.0 ml/m2 pre versus 66.3 ± 14.8 ml/m2 post; P < 0.01). There were no major complications in any of the 6 cases, and the early outcomes revealed satisfactory improvement of LVEF, reduction of LV volume, and reconstruction of the LV shape. There was an improvement in the New York Heart Association functional class in all cases (2.7 ± 0.5 pre versus 1.2 ± 0.4 post; P < 0.01). We have reported a review of 6 cases of successfully performed endoventricular spiral plication. We believe this novel technique can be effective for the surgical treatment of ischemic dilated cardiomyopathy.

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