Department of Cardiology, Na Homolce Hospital, Röentgenova 37/2, 150 30, Prague 5, Czech Republic.
Department of Cardiac Surgery, Na Homolce Hospital, Prague, Czech Republic.
J Cardiovasc Transl Res. 2021 Dec;14(6):1043-1050. doi: 10.1007/s12265-021-10133-9. Epub 2021 May 11.
The evidence supporting surgical aneurysmectomy in ischemic heart failure is inconsistent. The aim of the study was to describe long-term effect of minimally invasive hybrid transcatheter and minithoracotomy left ventricular (LV) reconstruction in patients with ischemic cardiomyopathy. Twenty-three subjects with transmural anterior wall scarring, LV ejection fraction 15-45%, and New York Heart Association class ≥ II were intervened using Revivent TC anchoring system. LV end-systolic volume index was reduced from 73.2 ± 27 ml at baseline to 51.5 ± 22 ml after 6 months (p < 0.001), 49.9 ± 20 ml after 2 years (p < 0.001), and 56.1 ± 16 ml after 5 years (p = 0.047). NYHA class improved significantly at 5 years compared to baseline. Six-min walk test distance increased at 2 years compared to the 6-month visit. Hybrid LV reconstruction using the anchoring system provides significant and durable LV volume reduction during 5-year follow-up in preselected patients with ischemic heart failure. Legend: Hybrid left ventricular reconstruction using the anchoring system provides significant and durable LV volume reduction throughout 5-year follow-up in preselected patients with ischemic heart failure.
支持缺血性心力衰竭手术动脉瘤切除术的证据并不一致。本研究的目的是描述微创杂交经导管和小开胸左心室（LV）重建术在缺血性心肌病患者中的长期效果。23 名前壁透壁性瘢痕、LV 射血分数 15-45%和纽约心脏协会（NYHA）心功能分级≥II 级的患者使用 Revivent TC 锚固系统进行干预。LV 收缩末期容积指数从基线时的 73.2 ± 27 ml 降低至 6 个月时的 51.5 ± 22 ml（p < 0.001）、2 年后的 49.9 ± 20 ml（p < 0.001）和 5 年后的 56.1 ± 16 ml（p = 0.047）。与基线相比，5 年后 NYHA 心功能分级显著改善。与 6 个月时相比，2 年后 6 分钟步行试验距离增加。在缺血性心力衰竭的预先选择患者中，使用锚固系统的杂交 LV 重建术在 5 年的随访中提供了显著且持久的 LV 容量减少。图例：在缺血性心力衰竭的预先选择患者中，使用锚固系统的杂交左心室重建术在 5 年的随访中提供了显著且持久的 LV 容量减少。
