HUSCAP logo Hokkaido Univ. logo

Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >

Estimating postoperative left ventricular volume : Identification of responders to surgical ventricular reconstruction

Creative Commons License

Files in This Item:
1-s2.0-S0022522318320038-mmc1.mp4Supplementary Data78.47 MBMP4 videoView/Open
Wakasa_JTCVS_2019_156_2088_96.pdf2.93 MBPDFView/Open
Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/76218

Title: Estimating postoperative left ventricular volume : Identification of responders to surgical ventricular reconstruction
Authors: Wakasa, Satoru Browse this author →KAKEN DB
Matsui, Yoshiro Browse this author →KAKEN DB
Kobayashi, Junjiro Browse this author
Cho, Yasunori Browse this author
Yaku, Hitoshi Browse this author
Matsumiya, Goro Browse this author
Isomura, Tadashi Browse this author
Takanashi, Shuichiro Browse this author
Usui, Akihiko Browse this author
Sakata, Ryuzo Browse this author
Komiya, Tatsuhiko Browse this author
Sawa, Yoshiki Browse this author
Saiki, Yoshikatsu Browse this author
Shimizu, Hideyuki Browse this author
Yamaguchi, Atsushi Browse this author
Hamano, Kimikazu Browse this author
Arai, Hirokuni Browse this author
Keywords: surgical ventricular reconstruction
ischemic cardiomyopathy
coronary artery bypass grafting
responder
Issue Date: Dec-2018
Publisher: Elsevier
Journal Title: Journal of Thoracic and Cardiovascular Surgery
Volume: 156
Issue: 6
Start Page: 2088
End Page: 2096
Publisher DOI: 10.1016/j.jtcvs.2018.06.090
Abstract: Objectives: The postoperative left ventricular end-systolic volume index and ejection fraction are benchmarks of surgical ventricular reconstruction but remain unpredictable. This study aimed to identify who could be associated with a higher long-term survival by adding surgical ventricular reconstruction to coronary artery bypass grafting than coronary artery bypass grafting alone (responders to surgical ventricular reconstruction). Methods: The subjects were 293 patients (median age, 63 years; 255 men) who underwent coronary artery bypass grafting for ischemic heart disease with left ventricular dysfunction in 16 cardiovascular centers in Japan. The relationships among surgical ventricular reconstruction, postoperative end-systolic volume index, ejection fraction, and survival were analyzed to identify responders to surgical ventricular reconstruction. Results: Surgical ventricular reconstruction was performed in 165 patients (56%). The end-systolic volume index and ejection fraction significantly improved (end-systolic volume index, 91 to 64 mL/m2; ejection fraction, 28% to 35%) for all patients. The postoperative end-systolic volume index and ejection fraction were estimated, and surgical ventricular reconstruction was found to be significantly associated with both end-systolic volume index (14.5 mL/m2 reduction, P < .001) and ejection fraction (3.1% increase, P = .003). During the median follow-up of 6.8 years, 69 patients (24%) died. Only the postoperative ejection fraction was significantly associated with survival (hazard ratio, 0.925; 95% confidence interval, 0.885-0.968), although this effect was limited to those with postoperative end-systolic volume index of 40 to 80 mL/m2 in the subgroup analysis (hazard ratio, 0.932; 95% confidence interval, 0.894-0.973). Conclusions: Adding surgical ventricular reconstruction to coronary artery bypass grafting could reduce the mortality risk by increasing ejection fraction for those with a postoperative end-systolic volume index within a specific range. The postoperative end-systolic volume index could demarcate responders to surgical ventricular reconstruction, and its estimation can help in surgical decision making.
Rights: © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article (author version)
URI: http://hdl.handle.net/2115/76218
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 松居 喜郎

Export metadata:

OAI-PMH ( junii2 , jpcoar )

MathJax is now OFF:


 

Feedback - Hokkaido University