Two-chamber contractile silhouette predicts severity of pre-operative hemodynamics in patients undergoing trisvr surgery

Abstract

Surgical left ventricular (LV) remodeling (TRISVR) is a procedure that both reduces LV volume and restores an elliptical LV endoventricular shape in patients with ischemic cardiomyopathy and low ejection fraction. Analysis of preoperative (pre-op) RAO 30° LV angiographic silhouettes has value in the selection of patients for TRISVR surgery. This report correlates pre-op contractile silhouette Types I-III with pre-op hemodynamic measurements affecting TRISVR surgical risk.Two-chamber LV contractile silhouette types describe residual regional LV chamber contractile function by identifying remaining contractile areas. The above three types of silhouettes uniquely described 61 of 68 consecutive patients undergoing TRISVR surgery. Patients underwent pre-op cardiac catheterization and transthoracic echocardiography with assessment of chamber volume, mean pulmonary artery pressure (PAP), mean pulmonary capillary pressure (Pcw), contractile EF% (regional EF% of most contractile areas), chamber EF%, and the presence and severity of mitral regurgitation (MR).