Endoventricular Spiral Plication for Ischemic Dilated Cardiomyopathy

Kayo Sugiyama,Masaho Okada,Hirotaka Watanuki,Genri Tagami,Yasuhiro Futamura,Katsuhiko Matsuyama

doi:10.4236/ojts.2019.91001

Abstract

Surgical ventricular restoration (SVR) procedures have been developed; however, their long-term effectiveness remains controversial. Although a series of endoventricular spiral plication (ESP) has been rarely reported and its long prognosis is still unknown; this method has a unique concept of left ventricular (LV) restoration without artificial patch materials. Here, we describe the case of a patient with ischemic cardiomyopathy and ischemic mitral regurgitation who successfully underwent ESP, mitral valve repair, and coronary artery bypass grafting. ESP was effective in papillary muscle approximation for avoiding heart failure; however, the noted improvement of LV wall thickening might be temporary.

Highlights

Cardiac transplantation, an accepted treatment option for patients with end-stage cardiac failure, is limited by severe shortages of donor hearts
A series of endoventricular spiral plication (ESP) has been rarely reported and its long prognosis is still unknown; this method has a unique concept of left ventricular (LV) restoration without artificial patch materials
We describe the case of a patient with ischemic cardiomyopathy and ischemic mitral regurgitation who successfully underwent ESP, mitral valve repair, and coronary artery bypass grafting

Summary

Introduction

An accepted treatment option for patients with end-stage cardiac failure, is limited by severe shortages of donor hearts. This procedure can be performed with a small incision of the LV wall and is expected in papillary muscle approximation with spiral suturing. This procedure is expected to detect another advantage in increase of LV wall thickness. Based on the etiology of MR in patients with ICM, restoration of the LV appears to restore the tethering of the mitral leaflet by surgical reverse remodeling of the LV. MR is treated by papillary muscle approximation to repair the mitral tethering [1] [6]

Case Report

Findings

Discussion