Ten-year experience of endocardial linear infarct exclusion technique for ischaemic cardiomyopathy.

Abstract

To report the mid-term results of our surgical ventricular restoration procedure, called the endocardial linear infarct exclusion technique (ELIET), for ischaemic cardiomyopathy. From 2006 to 2015, 43 consecutive patients who underwent surgical ventricular restoration with ELIET for ischaemic cardiomyopathy were retrospectively analysed. The mean age of patients at surgery was 65.3 ± 9.2 years and EuroSCORE II was 13.7 ± 12.0% (median 9.3%). The mean number of distal anastomoses of coronary artery bypass was 2.8 ± 1.5. A concomitant mitral procedure was performed in 58.1% of patients. The hospital mortality rate was 11.6% (5 patients). The ejection fraction was improved from 24.1 ± 9.2% to 31.7 ± 8.2% in 2 weeks after surgery. The end-systolic left ventricular volume index was effectively reduced, irrespective of performing a concomitant mitral procedure (reduction rate, ELIET: 35.6% vs ELIET + mitral: 39.2%). After ELIET, the sphericity index of the left ventricle did not worsen, and the conicity index was significantly improved. The 5-year estimated rates of survival and freedom from cardiac events were 71.3 ± 7.9 and 61.1 ± 8.3%, respectively. A concomitant mitral procedure was significantly associated with cardiac events based on univariate Cox hazard analysis. This study showed that ELIET can effectively reduce the ventricular volume and create an ellipsoidal left ventricle.