Shiota Takahiro, McCarthy Patrick M
Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA.
Echocardiography. 2002 Oct;19(7 Pt 1):605-12. doi: 10.1046/j.1540-8175.2002.00605.x.
The Dor procedure, or infarction excision surgery, was first used in 1984. It is a surgical treatment option for patients with end-stage ischemic heart failure. In a recently published multicenter study that included a total of 439 patients, average ejection fraction increased from 29 +/- 10% to 39 +/- 12% after surgery. In our experience, the overall survival rate 18 months after surgery is 89%, and the preoperative mortality rate is 6.6%. These results are similar to the previous reports from Dor's group, which confirmed the certain value of the surgery. Echocardiography, including intraoperative transesophageal echocardiography, plays an important role in clarifying cardiac anatomies, absolute left ventricular (LV) volumes, ejection fraction, and mitral regurgitation in patients with ischemic heart failure undergoing this surgery. With the development of ultrasound and computer technology, three-dimensional echocardiography may be preferred when evaluating the surgical results, including determination of absolute LV volumes. Communication between experienced cardiac surgeons and echocardiographers in the operating room is essential for successful outcomes and reliable evaluation of the surgery.
Dor手术，即梗死切除术，于1984年首次应用。它是终末期缺血性心力衰竭患者的一种手术治疗选择。在最近发表的一项纳入了总共439例患者的多中心研究中，术后平均射血分数从29±10%提高到了39±12%。根据我们的经验，术后18个月的总生存率为89%，术前死亡率为6.6%。这些结果与Dor团队之前的报告相似，证实了该手术的一定价值。超声心动图，包括术中经食管超声心动图，在明确接受该手术的缺血性心力衰竭患者的心脏解剖结构、左心室（LV）绝对容积、射血分数和二尖瓣反流方面发挥着重要作用。随着超声和计算机技术的发展，在评估手术结果（包括确定LV绝对容积）时，三维超声心动图可能更受青睐。经验丰富的心脏外科医生与超声心动图医生在手术室中的沟通对于取得成功的手术结果和对手术进行可靠评估至关重要。
