Surgical anterior ventricular endocardial restoration (SAVER) for dilated ischemic cardiomyopathy.
Surgical anterior ventricular endocardial restoration (SAVER) for dilated ischemic cardiomyopathy.
复制标题
手术前室心内膜修复（SAVER）治疗扩张型缺血性心肌病。
DOI：
10.1053/stcs.2001.30372
复制
发表时间：
2001
影响因子：
2.5
通讯作者：
W. Siler
中科院分区：
文献类型：
--
作者：
C. Athanasuleas;A. Stanley;G. Buckberg;V. Dor;M. Donato;W. Siler
前壁梗死改变心室形状和体积。运动不能最常见于早期再灌注后。运动障碍在没有再灌注的情况下发展。两者都是由于远端肌肉功能障碍而导致心力衰竭。传统的外科手术治疗运动障碍。本研究评估了手术前室内膜修复术（SAVER），该手术排除了运动不能和运动障碍的心尖和间隔瘢痕。一个由来自13个中心的心脏病专家和外科医生组成的新的国际小组（RESTORE小组）研究了前壁梗死后缺血性心肌病的SAVER。从1998年1月至2000年7月，662例患者接受了手术。研究了早期和3年的结果。伴随手术包括92%的冠状动脉旁路移植术（CABG）、22%的二尖瓣修复术和3%的二尖瓣置换术。住院死亡率为7.7%。606例SAVER和CABG患者的死亡率为4.9%。在147例同时行二尖瓣修复术的患者中，这一比例为8.1%。少数患者需要IABP（8.4%）、LVAD（0.4%）或ECMO（0.6%）。术后射血分数从29.7% ± 11.3%增加到40.0% ± 12.3%，左心室收缩末期容积从96 ± 63减少到62 ± 39 mL/m2（P <0.01）。05）。3年生存率为89.4% ± 1.3%。术前血容量>80 mL/m2的患者的生存率低于血容量≤ 80 mL/m2的患者（83.5% +/- 3.3% vs 94.5% +/- 2.0%）。3年时无心力衰竭再入院率为88.7%，与术前容量无关。SAVER是治疗前壁心肌梗死后扩张的前室重构的安全有效的方法。
Anterior infarction changes ventricular shape and volume. Akinesia is most commonly observed after early reperfusion. Dyskinesia develops in the absence of reperfusion. Both produce heart failure by dysfunction of the remote muscle. Traditional surgery deals with dyskinesia. This study evaluates surgical anterior ventricular endocardial restoration (SAVER), an operation that excludes the apical and septal scar in both akinesia and dyskinesia. A new international group of cardiologists and surgeons from 13 centers, the RESTORE Group) investigated SAVER in ischemic cardiomyopathy following anterior infarction. From January 1998 to July 2000, 662 patients underwent surgery. Early and 3-year outcomes were investigated. Concomitant procedures included coronary artery bypass grafting (CABG) in 92%, mitral repair in 22%, and mitral replacement in 3%. Hospital mortality was 7.7%. Mortality among 606 patients with SAVER and CABG alone was 4.9%. It was 8.1% among 147 patients who underwent concomitant mitral valve repair. Few patients required IABPs (8.4%), LVADs (0.4%), or ECMO (0.6%). Postoperatively, ejection fraction increased from 29.7% +/- 11.3% to 40.0% +/- 12.3% and left ventricular end systolic volume decreased from 96 +/- 63 to 62 +/- 39 mL/m(2) (P <. 05). At 3 years, the survival rate was 89.4% +/- 1.3%. Survival was lower among those with preoperative volume >80 mL/m(2) compared with volume < or = 80 mL/m(2) (83.5% +/- 3.3% v 94.5% +/- 2.0%). Freedom from readmission to hospital for heart failure was at 88.7% at 3 years and was not related to preoperative volume. SAVER is a safe and effective procedure for treating the remodeled dilated anterior ventricle following anterior myocardial infarction.
DOI：
10.1016/0735-1097(92)90314-d
发表时间：
1992-05-01
影响因子：
24
作者：
MITCHELL, GF;LAMAS, GA;PFEFFER, MA
通讯作者：
PFEFFER, MA
DOI：
10.1016/0735-1097(88)90159-3
发表时间：
1988-01-01
影响因子：
24
作者：
WARREN, SE;ROYAL, HD;MCKAY, RG
通讯作者：
MCKAY, RG