Left Ventricular Reconstruction Surgery in Candidates for Heart Transplantation.
OBJECTIVE
To report our center's experience in the surgical treatment of ventricular reconstruction, an effective and efficient technique that allows patients with end-stage heart failure of ischemic etiology to have clinical improvement and increased survival.


METHODS
Observational, clinical-surgical, sequential, retrospective study. Patients with ischemic cardiomyopathy and left ventricular aneurysm were attended at the Heart Failure, Ventricular Dysfunction and Cardiac Transplant outpatient clinic of the Dante Pazzanese Cardiology Institute, from January 2010 to December 2016. Data from 34 patients were collected, including systemic arterial hypertension, ejection fraction, New York Heart Association (NYHA) functional classification (FC), European System for Cardiac Operative Risk Evaluation (EuroSCORE) II value, Society of Thoracic Surgeons (STS) score, ventricular reconstruction technique, and survival.


RESULTS
Overall mortality of 14.7%, with hospital admission being 8.82% and late death being 5.88%. Total survival rate at five years of 85.3%. In the preoperative phase, NYHA FC was Class I in five patients, II in 18, III in eight, and IV in three vs. NYHA FC Class I in 17 patients, II in eight, III in six, and IV in three, in the postoperative period. EuroSCORE II mean value was 6.29, P≤0.01; hazard ratio (HR) 1.16 (95% confidence interval [CI] 1.02-1.31). STS mortality/morbidity score mean value was 18.14, P≤0.004; HR 1.19 (95% CI 1.05-1.33). Surgical techniques showed no difference in survival among Dor 81% vs. Jatene 91.7%.


CONCLUSION
Surgical treatment of left ventricular reconstruction in candidates for heart transplantation is effective, efficient, and safe, providing adequate survival.
['Contreras|Carlos Alberto Méndez|CAM|', 'Orellana|Pedro Xavier|PX|', 'Almeida|Antonio Flávio Sanchez de|AFS|', 'Finger|Marco Aurélio|MA|', 'Rossi|João Manoel|JM|', 'Chaccur|Paulo|P|']
D000368:Aged D009202:Cardiomyopathies D005260:Female D006322:Heart Aneurysm D016027:Heart Transplantation D006352:Heart Ventricles D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D017202:Myocardial Ischemia D011183:Postoperative Complications D016016:Proportional Hazards Models D019651:Reconstructive Surgical Procedures D012189:Retrospective Studies D013318:Stroke Volume D015996:Survival Rate D013997:Time Factors D016896:Treatment Outcome
Heart Transplantation Survival Rate Cardiac Surgical Procedures Heart Aneurysm Stroke Volume