In the present study, we analyzed left ventricular energetics in patients who underwent the dor procedure. We investigated the preoperative predictors and defined the. The repair involves endoventricular circular patch plasty and application of gelatinresorcinolformaldehyde biological glue in the space between a teflon felt patch on the infarcted septum and a bovine. Relation to surgical outcome in patients undergoing endoventricular circular patch plasty repair. Its use in a patient resulted in an almost normal shaped continue reading. Its use in a patient resulted in an almost normal shaped. Biventricular pacing with coronary bypass and dors. Endoventricular circular patch plasty is considered in patients with ischemic cardiomyopathy, large anterior wall akinetic or dyskinetic segments, and a spherically dilated lv. Between 1996 and 2001,23 consecutive patients with left ventricular aneurysm andor ischemic cardiomyopathy after myocardial infarction who underwent dor operation were. Reverse remodeling after endoventricular circular patch. Many believe that dyskinesia is the only predictor of favorable surgical outcome after large myocardial infarction and that akinetic scars do not recover well in patients with globally depressed ventricular function. Ismics 8th annual meeting program midterm results after. Modified endoventricular circular plasty dor procedure.
A 17year experience vincent dar, marisa di donato, michel sabatier, franfoise montiglio, filippo civaia, and the restore group the first experience with endoventricular circular patch plasty evcpp was reported in 1984 as a surgical method to rebuild left ventricular lv geometry made more spheric after. We describe a technique for repairing the ventricular septal perforation 10 days post acute anteroseptal myocardial infarction using the modified infarction exclusion method. Jan 25, 2016 dor operation endoventricular circular patch plasty. Surgical management of left ventricular aneurysms by the. Endoventricular circular patch plasty dor operation ctsnet. Left ventricular volume and function after endoventricular.
Left ventricular reconstruction by endoventricular circular. This allows to exclude all asynergic areas of the left ventricular wall and reshape the remaining wall. Dor operation endoventricular circular patch plasty youtube. This video demonstrates two cases of left ventricular circular patch plasty dor operation for large. Between 1996 and 2001,23 consecutive patients with left ventricular aneurysm andor ischemic cardiomyopathy after. The geometric reconstruction of the left ventricle with intraventricular patch dors operation is also performed in ischemic. This study evaluates clinical and hemodynamic results of endoventricular circular patch plasty in patients with either large akinetic scar n 51 or large dyskinetic scar n 49 and depressed left ventricular function ejection fraction endoventricular circular patch plasty technique. Few modifications in his technique of simple resection and. Dor operation endoventricular circular patch plasty video. This retrospective study attempted to relate surgical outcome with the extent and type of preoperative wall motion asynergy in patients with postinfarction myocardial scar who underwent endoventricular circular patch plasty repair and associated coronary grafting. Modified endoventricular circular plasty dor procedure ctsnet. All seven patients had anterior left ventricular aneurysms following old myocardial infarction. Ventricular energetics in endoventricular circular patch plasty for dyskinetic anterior left ventricular aneurysm.
Endoventricular circular patch plasty or septoexclusion antonio maria calafiore m. In 1985, dor introduced evcpp as a viable method for restoring a dilated left ventricle lv to its normal, elliptical geometry. Standard technique of evcpp the surgical procedure is described in figure 1, and routine transesophageal echocardiographic. The repair involves endoventricular circular patch plasty and application of gelatinresorcinolformaldehyde biological glue in the space between a teflon felt patch on the infarcted septum and a bovine pericardial patch in the left ventricular cavity. The dor procedure, which uses a circular suture and a dacron patch to correct lv aneurysms and exclude scarred parts of the. Dor operation endoventricular circular patch plasty. The repair involves endoventricular circular patch plasty and application of gelatinresorcinolformaldehyde biological glue in the space between a teflon felt patch on the infarcted septum and a bovine pericardial patch. Didonato m, sabatier m, dor v, toso a, maioli m, fantini f. In 1984, dor used endoventricular circular patch plasty the dor procedure to restore lv size and shape by excluding the infarcted anterior lv wall and the interventricular septum in patients with ischemic cardiomyopathy and either an akinetic or dyskinetic anterior wall. Left ventricular reconstruction was performed with endoventricular circular patch plasty evcpp dor procedure or linear repair technique. Left ventricular reconstruction by endoventricular circular patch plasty repair.
Google scholar see all references and we first employed the technique of endoventricular circular patch plasty evcpp in 1984. The endoventricular circular patch plasty dor procedure. We used the qgs method to evaluate regional wall function in the early and the midterm period after endoventricular circular patch plasty evcpp. Ventricular energetics in endoventricular circular patch. Dor procedure or the endoventricular circular patch plasty evccp, is an operation, introduced by vincent dor, in 1985.
Endoventricular circular patch plasty or septoexclusion septoexclusion is a technique described by guilmet in the mid 1980s. Surgical management of left ventricular aneurysms by. Between october 1997 and may 2001, 22 patients 19 males and 3 females. He has improved much after the operation and is now in new york heart association nyha functional class ii.
Endoventricular circular patch plasty or septoexclusion, journal of cardiac surgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Our study group consists of 12 patients which were operated on with the diagnossis of left ventricular aneurysm. In anterior infarction, the free lv wall and septum are scarred and become dyskinetic or akinetic. Efficacy of endoventricular circular patch plasty springerlink.
Early and midterm results of endoventricular circular patch plasty dor procedure concomitant with total arterial revascularization were studied. The procedure itself is a viable method of restoring a dilated left ventricle to its normal eliptical geometry. The endoventricular circular patch plasty dor procedure applies to patients with a left ventricular dysfunction due to an ischemic dilated ventricle. In 1985, vincent dor, md, introduced endoventricular circular patch plasty evcpp, or the dor procedure, as a viable method for restoring a dilated left ventricle to its normal, elliptical geometry. From 1984 to 2000, 950 left ventricular ischemic asynergy dyskinetic or akinetic were operated using the endoventricular circular patch plasty technique. Department of cardiology and cardiac surgery, university g. In this procedure, the lv volume is reduced and the lv chamber is reconstructed using an endoventricular circular patch. Dilated cardiomyopathy, endoventricular circular patch plasty. Left ventricular reconstructive surgery modified dor. This video demonstrates two cases of left ventricular circular patch plasty dor operation for large akinetic postinfarction aneurysms.
Postinfarction ventricular septal perforation repair with. The dor procedure is a medical technique used as part of heart surgery and originally introduced by the french cardiac surgeon vincent dor b. Although the early result of endoventricular circular patch plasty evcpp has been reported, few are seen about the longterm results. For bvp, a permanent screwintype epicardial lead 507155, medtronic, minneapolis, mn was fixed on the posterolateral wall near the atrioventricular groove, and the other two leads 5075 and 4951m53, medtronic, minneapolis, mn were placed near the right ventricular. The consequence is dilated ischemic cardiomyopathy. Left ventricular reconstructive surgery modified dor procedure. We performed the dacron patch fixation to the left ventricle with. In 1958, cooley resected a left ventricular aneurysm lva while using cardiopulmonary bypass to sustain the systemic circulation, thereby ushering in the modern era of surgery for left ventricular aneurysms. Its use in a patient resulted in an almost normal shaped interventricular septum and left. Citeseerx document details isaac councill, lee giles, pradeep teregowda. It is necessary that preoperative factors predicting the postoperative course be easily and precisely documented. Application of circular patch plasty dor procedure or.
Between april 1994 and april 2004, 31 patients underwent the evcpp to repair an anterior left ventricular aneurysm. The various drawbacks related to this technique can be offset by a modification based on a mathematical hypothesis, which should result in a more physiological ventricular geometry, with consequent late reverse remodeling and. A 17year experience vincent dar, marisa di donato, michel sabatier, franfoise montiglio, filippo civaia, and the restore group the first experience with endoventricular circular patch plasty evcpp was reported in 1984 as a surgical method to rebuild left ventricular lv geometry made more. Both morphology and hemodynamic of left ventricle, are improved. Endoventricular circular patch plasty repair dor, or modified dor, procedure to credit vincent dor, md, who authored many articles on the procedure he began performing in the early 1980s surgical ventricular restoration. The mean age of the patients at the time of surgery was 63 years old. Endoventricular circular patch plasty dor operation vumedi. Early results after surgical treatment of left ventricular. Endoventricular circular patch plasty for endstage. We studied left ventricular lv function in the early and midterm periods after evcpp with electrocardiographicgated single photon emission computed tomography gated spect.
The patient underwent surgery where left ventricular volume reduction using endoventricular circular patch plasty evcpp and mitral valve replacement mvr were performed. It is also known as endoventricular circular patch plasty evcpp. Preoperative parameters predicting the postoperative course of endoventricular circular patch plasty keiichiro kondo, md, yoshihide sawada, md, and shinjiro sasaki, md, phd it is necessary that preoperative factors predicting the postoperative course be easily and precisely documented. The surgical ventricular restoration svr procedure may also be referred to as ventricular remodeling, surgical anterior ventricular endocardial restoration saver, left ventricular reconstructive surgery, left ventricular aneurysmectomy reconstruction, endoventricular circular plasty, or the dor procedure. Pre and postoperative 1, 2, 6, and 12month clinical outcomes of the patients mean. Left ventricular aneurysm lva is a serious complication of myocardial infarction and reduces the chances of survival.
Left ventricular lv pump function improvement is difficult to predict after aneurysmectomy, for either. This technique restores circular ventricular architecture by excluding the septal scar and, by means of the laplace relationship, reducing the cavity to restore wall tension toward normal and thereby improve hemodynamic status. Endoventricular circular patch plasty dor operation. Left ventricular lv pump function improvement is difficult to predict after. Lessons from a mathematical hypothesis modification of. This study evaluates clinical and hemodynamic results of endoventricular circular patch plasty in patients with either large akinetic scar n 51 or. Controversy still exists regarding the optimal surgical technique for lva repair. We analyze the efficacy of two techniques, linear vs. Preoperative parameters predicting the postoperative article. Linear endoventricular patch plasty resulted in a decrease in enddiastolic volume edv of 40. Left ventricular reconstruction by endoventricular. The surgical technique of linear endoventricular patch plasty. Dor procedure definition of dor procedure by medical. Dor v, saab m, coste p, kornaszewska m, montiglio i.
Circular reorganization of l v wall for lvr the concept of circular reorganization of the dis eased lv was proposed in 1984 and described as endoventricular circular patch plasty evcpp. Between july 1987 and march 1996, 562 patients underwent endoventricular patch plasty repair and coronary grafting for postinfarction lv aneurysm at the cardiothoracique center of monaco. Endoventricular circular patch plasty for endstage valvular. Jan 26, 2015 endoventricular circular patch plasty dor operation. Sixtyone patients who underwent the dor procedure for ischemic dyskineticakinetic left ventricle were studied with mean followup of 26. Tanoue y, ando h, fukumura f, umesue m, uchida t, taniguchi k, et al.
Original article preoperative parameters predicting the. A 66yearold male patient was admitted to our hospital for treatment of nyha class iv heart failure. We investigated the preoperative predictors and defined the indications of endoventricular circular patch plasty evcpp in patients with ischemic cardiomyopathy icm. Nov 21, 2012 left ventricular aneurysm lva is a serious complication of myocardial infarction and reduces the chances of survival. Initial valve surgery was an aortic valve replacement avr with mechanical tilting disc valve for rheumatic aortic. The technique of surgical ventricular restoration employed in the stich trial was circular endoventricular patch plasty. Journal of the american college of cardiology, 1997, 27, 1569 1575. Preoperative parameters predicting the postoperative. Figure 2 from postinfarction ventricular septal perforation. Endoventricular circular patch plasty or septoexclusion.
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