Journal of the american college of cardiology, 1997, 27, 1569 1575. Dor operation endoventricular circular patch plasty youtube. It is necessary that preoperative factors predicting the postoperative course be easily and precisely documented. Dor procedure definition of dor procedure by medical. Left ventricular reconstruction by endoventricular. Preoperative parameters predicting the postoperative. Left ventricular lv pump function improvement is difficult to predict after aneurysmectomy, for either.
Endoventricular circular patch plasty or septoexclusion antonio maria calafiore m. Standard technique of evcpp the surgical procedure is described in figure 1, and routine transesophageal echocardiographic. Pre and postoperative 1, 2, 6, and 12month clinical outcomes of the patients mean. The aim of this our study is to indicate that the endoventricular circular patch plasty evcpp which is recommended by dor can be performed with a simpler and more hemostatic suture technique. Sixtyone patients who underwent the dor procedure for ischemic dyskineticakinetic left ventricle were studied with mean followup of 26. 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. Early and midterm results of endoventricular circular patch plasty dor procedure concomitant with total arterial revascularization were studied. In anterior infarction, the free lv wall and septum are scarred and become dyskinetic or akinetic. The surgical technique of linear endoventricular patch plasty. Dor v, saab m, coste p, kornaszewska m, montiglio i. Preoperative parameters predicting the postoperative article. 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.
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. Google scholar see all references and we first employed the technique of endoventricular circular patch plasty evcpp in 1984. Original article preoperative parameters predicting the. We performed the dacron patch fixation to the left. Ventricular energetics in endoventricular circular patch. Tanoue y, ando h, fukumura f, umesue m, uchida t, taniguchi k, et al. Dor procedure or the endoventricular circular patch plasty evccp, is an operation, introduced by vincent dor, in 1985. The endoventricular circular patch plasty dor procedure applies to patients with a left ventricular dysfunction due to an ischemic dilated ventricle. Department of cardiology and cardiac surgery, university g. 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. In 1985, dor introduced evcpp as a viable method for restoring a dilated left ventricle lv to its normal, elliptical geometry. Endoventricular circular patch plasty dor operation vumedi. Citeseerx document details isaac councill, lee giles, pradeep teregowda. Endoventricular circular patch plasty dor operation ctsnet.
Left ventricular reconstruction by endoventricular circular. Postinfarction ventricular septal perforation repair with. Lessons from a mathematical hypothesis modification of. Dors endoventricular circular patch plasty was then performed. In this procedure, the lv volume is reduced and the lv chamber is reconstructed using an endoventricular circular patch. It is also known as endoventricular circular patch plasty evcpp. 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. We used the qgs method to evaluate regional wall function in the early and the midterm period after endoventricular circular patch plasty evcpp. Its use in a patient resulted in an almost normal shaped. We analyze the efficacy of two techniques, linear vs. We describe a technique for repairing the ventricular septal perforation 10 days post acute anteroseptal myocardial infarction using the modified infarction exclusion method. The dor procedure, which uses a circular suture and a dacron patch to correct lv aneurysms and exclude scarred parts of the.
In the present study, we analyzed left ventricular energetics in patients who underwent the dor procedure. Between april 1994 and april 2004, 31 patients underwent the evcpp to repair an anterior left ventricular aneurysm. We report hemodynamic and clinical results of our series of endoventricular circular patch plasty dor operation and consider some advantages of this procedure for patients with ischemic cardiomyopathy. A 66yearold male patient was admitted to our hospital for treatment of nyha class iv heart failure. Efficacy of endoventricular circular patch plasty springerlink. Endoventricular circular patch plasty for endstage valvular.
Its use in a patient resulted in an almost normal shaped interventricular septum and left. The patient underwent surgery where left ventricular volume reduction using endoventricular circular patch plasty evcpp and mitral valve replacement mvr were performed. He has improved much after the operation and is now in new york heart association nyha functional class ii. 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. We performed the dacron patch fixation to the left ventricle with.
Left ventricular reconstructive surgery modified dor. Application of circular patch plasty dor procedure or. The consequence is dilated ischemic cardiomyopathy. We investigated the preoperative predictors and defined the indications of endoventricular circular patch plasty evcpp in patients with ischemic cardiomyopathy icm. Left ventricular reconstruction was performed with endoventricular circular patch plasty evcpp dor procedure or linear repair technique. The dor procedure is a medical technique used as part of heart surgery and originally introduced by the french cardiac surgeon vincent dor b. 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. Left ventricular reconstruction by endoventricular circular patch plasty repair.
Endoventricular circular patch plasty for endstage. The technique of surgical ventricular restoration employed in the stich trial was circular endoventricular patch plasty. 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 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 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. 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. 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. 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. Few modifications in his technique of simple resection and. Early results after surgical treatment of left ventricular. Endoventricular circular patch plasty dor procedure has been reported to be a surgical method that applies to patients with a left ventricular lv dysfunction after a myocardial infarction for either akinesia or dyskinesia. 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.
This video demonstrates two cases of left ventricular circular patch plasty dor operation for large akinetic postinfarction aneurysms. Left ventricular reconstructive surgery modified dor procedure. 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. 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. Endoventricular circular patch plasty dor operation. 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. Between october 1997 and may 2001, 22 patients 19 males and 3 females. The geometric reconstruction of the left ventricle with intraventricular patch dors operation is also performed in ischemic. Although the early result of endoventricular circular patch plasty evcpp has been reported, few are seen about the longterm results. Ismics 8th annual meeting program midterm results after.
This allows to exclude all asynergic areas of the left ventricular wall and reshape the remaining wall. Jan 25, 2016 dor operation endoventricular circular patch plasty. Left ventricular lv pump function improvement is difficult to predict after. 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 myocardial infarction. Its use in a patient resulted in an almost normal shaped continue reading. The procedure itself is a viable method of restoring a dilated left ventricle to its normal eliptical geometry. From 1984 to 2000, 950 left ventricular ischemic asynergy dyskinetic or akinetic were operated using the endoventricular circular patch plasty technique. Modified endoventricular circular plasty dor procedure ctsnet. Left ventricular volume and function after endoventricular. The endoventricular circular patch plasty dor procedure.
We investigated the preoperative predictors and defined the. Both morphology and hemodynamic of left ventricle, are improved. Initial valve surgery was an aortic valve replacement avr with mechanical tilting disc valve for rheumatic aortic. Surgical management of left ventricular aneurysms by the. Dor operation endoventricular circular patch plasty video. 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. Controversy still exists regarding the optimal surgical technique for lva repair. Dilated cardiomyopathy, endoventricular circular patch plasty. Endoventricular circular patch plasty is considered in patients with ischemic cardiomyopathy, large anterior wall akinetic or dyskinetic segments, and a spherically dilated lv.
Linear endoventricular patch plasty resulted in a decrease in enddiastolic volume edv of 40. Endoventricular circular patch plasty or septoexclusion septoexclusion is a technique described by guilmet in the mid 1980s. Dor procedure definition of dor procedure by medical dictionary. Relation to surgical outcome in patients undergoing endoventricular circular patch plasty repair. Between 1996 and 2001,23 consecutive patients with left ventricular aneurysm andor ischemic cardiomyopathy after myocardial infarction who underwent dor operation were. Our study group consists of 12 patients which were operated on with the diagnossis of left ventricular aneurysm. 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. This study evaluates clinical and hemodynamic results of endoventricular circular patch plasty in patients with either large akinetic scar n 51 or. Didonato m, sabatier m, dor v, toso a, maioli m, fantini f. Left ventricular aneurysm lva is a serious complication of myocardial infarction and reduces the chances of survival. Figure 2 from postinfarction ventricular septal perforation. Biventricular pacing with coronary bypass and dors.
All seven patients had anterior left ventricular aneurysms following old myocardial infarction. Reverse remodeling after endoventricular circular patch. 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. Modified endoventricular circular plasty dor procedure. Jan 26, 2015 endoventricular circular patch plasty dor operation.
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