Objectives: Ischemic cardiomyopathy (ICM) associated with advanced ventricular remodeling remains a surgical challenge. The purpose of this study was to evaluate long-term clinical and echocardiographic results following surgical ventricular reconstruction (SVR).
Methods: From 1999 to 2009, 34 consecutive ICM patients with ejection fraction less than 35% underwent SVR. Cardiac catheterization was examined before and after surgery. Clinical follow-up and serial echocardiographic examinations were performed at baseline, 1 month, and annually thereafter.
Results: Hospital mortality was 6% (n = 2) and the overall survival rate after 5 years was 70%. Angiogram findings revealed a reduction of left ventricular end-systolic volume index (112 +/- 47 ml/m2 vs. 62 +/- 28 ml/m2, p < 0.05) and improved left ventricular ejection fraction at 1 month after SVR. Serial echocardiogram findings demonstrated that significant reduction of left ventricular dimension was maintained along with well-controlled mitral regurgitation until 3 years after SVR.
Conclusion: In ICM patients, SVR restored left ventricular geometry and functions. Long-term followup with optimized medical treatment is necessary after SVR.