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Midterm Outcome of Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for the Treatment of Ischemic Heart Failure

BACKGROUND: Left ventricular (LV) remodeling after anterior myocardial infarction (AMI) can cause a pathological increase in LV volume, reduction in LV ejection fraction (EF), and symptomatic heart failure (HF). This study evaluates the midterm results of a hybrid transcatheter and minimally invasiv...

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Autores principales: Hegeman, Romy R.M.J.J., Swaans, Martin J., Van Kuijk, Jan-Peter, Klein, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242554/
https://www.ncbi.nlm.nih.gov/pubmed/37288056
http://dx.doi.org/10.1016/j.shj.2022.100081
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author Hegeman, Romy R.M.J.J.
Swaans, Martin J.
Van Kuijk, Jan-Peter
Klein, Patrick
author_facet Hegeman, Romy R.M.J.J.
Swaans, Martin J.
Van Kuijk, Jan-Peter
Klein, Patrick
author_sort Hegeman, Romy R.M.J.J.
collection PubMed
description BACKGROUND: Left ventricular (LV) remodeling after anterior myocardial infarction (AMI) can cause a pathological increase in LV volume, reduction in LV ejection fraction (EF), and symptomatic heart failure (HF). This study evaluates the midterm results of a hybrid transcatheter and minimally invasive surgical technique to reconstruct the negatively remodeled LV by myocardial scar plication and exclusion with microanchoring technology. METHODS: Retrospective single-center analysis of patients who underwent hybrid LV reconstruction (LVR) with the Revivent TransCatheter System. Patients were accepted for the procedure when they presented with symptomatic HF (New York Heart Association class ≥ II, EF < 40%) after AMI, in the presence of a dilated LV with either akinetic or dyskinetic scar in the anteroseptal wall and/or apex of ≥50% transmurality. RESULTS: Between October 2016 and November 2021, 30 consecutive patients were operated. Procedural success was 100%. Comparing echocardiographic data preoperatively and directly postoperatively, LVEF increased from 33 ± 8% to 44 ± 10% (p < 0.0001). LV end-systolic volume index decreased from 58 ± 24 mL/m(2) to 34 ± 19 mL/m(2) (p < 0.0001) and LV end-diastolic volume index decreased from 84 ± 32 mL/m(2) to 58 ± 25 mL/m(2) (p < 0.0001). Hospital mortality was 0%. After a mean follow-up of 3.4 ± 1.3 years, there was a significant improvement of New York Heart Association class (p = 0.001) with 76% of surviving patients in class I-II. CONCLUSIONS: Hybrid LVR for symptomatic HF after AMI is safe and results in significant improvement in EF, reduction in LV volumes, and sustained improvement in symptoms.
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spelling pubmed-102425542023-06-07 Midterm Outcome of Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for the Treatment of Ischemic Heart Failure Hegeman, Romy R.M.J.J. Swaans, Martin J. Van Kuijk, Jan-Peter Klein, Patrick Struct Heart Original Research BACKGROUND: Left ventricular (LV) remodeling after anterior myocardial infarction (AMI) can cause a pathological increase in LV volume, reduction in LV ejection fraction (EF), and symptomatic heart failure (HF). This study evaluates the midterm results of a hybrid transcatheter and minimally invasive surgical technique to reconstruct the negatively remodeled LV by myocardial scar plication and exclusion with microanchoring technology. METHODS: Retrospective single-center analysis of patients who underwent hybrid LV reconstruction (LVR) with the Revivent TransCatheter System. Patients were accepted for the procedure when they presented with symptomatic HF (New York Heart Association class ≥ II, EF < 40%) after AMI, in the presence of a dilated LV with either akinetic or dyskinetic scar in the anteroseptal wall and/or apex of ≥50% transmurality. RESULTS: Between October 2016 and November 2021, 30 consecutive patients were operated. Procedural success was 100%. Comparing echocardiographic data preoperatively and directly postoperatively, LVEF increased from 33 ± 8% to 44 ± 10% (p < 0.0001). LV end-systolic volume index decreased from 58 ± 24 mL/m(2) to 34 ± 19 mL/m(2) (p < 0.0001) and LV end-diastolic volume index decreased from 84 ± 32 mL/m(2) to 58 ± 25 mL/m(2) (p < 0.0001). Hospital mortality was 0%. After a mean follow-up of 3.4 ± 1.3 years, there was a significant improvement of New York Heart Association class (p = 0.001) with 76% of surviving patients in class I-II. CONCLUSIONS: Hybrid LVR for symptomatic HF after AMI is safe and results in significant improvement in EF, reduction in LV volumes, and sustained improvement in symptoms. Elsevier 2022-08-30 /pmc/articles/PMC10242554/ /pubmed/37288056 http://dx.doi.org/10.1016/j.shj.2022.100081 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Hegeman, Romy R.M.J.J.
Swaans, Martin J.
Van Kuijk, Jan-Peter
Klein, Patrick
Midterm Outcome of Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for the Treatment of Ischemic Heart Failure
title Midterm Outcome of Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for the Treatment of Ischemic Heart Failure
title_full Midterm Outcome of Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for the Treatment of Ischemic Heart Failure
title_fullStr Midterm Outcome of Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for the Treatment of Ischemic Heart Failure
title_full_unstemmed Midterm Outcome of Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for the Treatment of Ischemic Heart Failure
title_short Midterm Outcome of Hybrid Transcatheter and Minimally Invasive Left Ventricular Reconstruction for the Treatment of Ischemic Heart Failure
title_sort midterm outcome of hybrid transcatheter and minimally invasive left ventricular reconstruction for the treatment of ischemic heart failure
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242554/
https://www.ncbi.nlm.nih.gov/pubmed/37288056
http://dx.doi.org/10.1016/j.shj.2022.100081
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