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논문 기본 정보

자료유형
학술저널
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저널정보
대한자기공명의과학회 Investigative Magnetic Resonance Imaging Investigative Magnetic Resonance Imaging 제12권 제1호
발행연도
2008.1
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40 - 48 (9page)

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Purpose : We sought to determine the early change of ventricular geometry and function after concomitant surgeries of modified Dor procedure and mitral valve annuloplasty by using magnetic resonance imaging. Materials and Methods : We enrolled 21 patients with dilated heart failure who underwent modified Dor procedure (n=8), mitral valve annuloplasty (n=6), or both surgeries (n=7). Cine MRI was used to assess left ventricular dimensions and function before and after surgery. We measured the left ventricular end-diastolic and end-systolic volumes and the dimensions of the left ventricular long-axis and shortaxis. Left ventricular stroke volume, ejection fraction, and sphericity index were calculated from these measurements. These parameters were analyzed and compared between three different surgery groups to explain the combined effect of the concomitant surgeries. Results : MRI was performed within average 12 ± 15 days (range 1-58 days) before and 38 ± 50 days (range 7- 231 days) after the surgery. The patients who underwent concomitant surgeries had more profound enlargement of left ventricle and decreased contractility prior to surgery than those in the patients who underwent single surgical procedure. Left ventricular end-diastolic volume and endsystolic volume significantly decreased in all patients regardless of surgery type after surgery. Ejection fraction significantly increased only in the patients who got modified Dor procedure without mitral valve annuloplasty (25.4% to 40.7%). Sphericity index increased in patients with modified Dor procedure but decreased in patients with mitral valve annuloplasty (0.65 to 0.78 vs. 0.75 to 0.65). In the patients who underwent concomitant surgeries showed no significant change in sphericity index after surgery. Conclusion : The early change of the left ventricular geometry and function after the concomitant surgeries with modified Dor procedure and mitral valve annuloplasty in patients with dilated heart failure includes a marked reduction in left ventricular volume and in stroke volume. The shape of the left ventricle does not change because the effect of sphericity index decrease from mitral valve annuloplasty is counteracted by the effect of sphericity index increase from modified Dor procedure. Improvement of left ventricular ejection fraction is not the early change after the concomitant surgeries.
#Surgical Ventricular Restoration Left Ventricular Volume Reduction Surgery Dor Procedure Mitral Annuloplasty Magnetic Resonance Imaging

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참고문헌 (15)

참고문헌 신청
Bolling SF / 1998 / Intermediate-term outcome of mitral reconstruction in cardiomyopathy / J Thorac Cardiovasc Surg (381) : 381 ~ 386 google schola Chang BC / 2001 / Volume reduction surgery for end-stage heart failure: experience in Korea / J Card Surg 16 : 159 ~ 164 google schola Dang AB / 2005 / Effect of ventricular size and patch stiffness in surgical anterior ventricular restoration: a finite element model study / Ann Thorac Surg 79 : 185 ~ 193 google schola Di Donato M / 2001 / Effects of the Dor procedure on left ventricular dimension and shape and geometric correlates of mitral regurgitation one year after surgery / J Thorac google schola Dor V / 2001 / Left ventricular reconstruction by endoventricular circular patch plasty repair: a 17-year experience / Semin Thorac Cardiovasc Surg 13 : 435 ~ 447 google schola

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