Ten-year experience of endocardial linear infarct exclusion technique for ischaemic cardiomyopathy

Abstract

OBJECTIVES: To report the mid-term results of our surgical ventricular restoration procedure, called the endocardial linear infarct exclusion technique (ELIET), for ischaemic cardiomyopathy. METHODS: From 2006 to 2015, 43 consecutive patients who underwent surgical ventricular restoration with ELIET for ischaemic cardiomyopathy were retrospectively analysed. RESULTS: The mean age of patients at surgery was 65.3 ± 9.2 years and EuroSCORE II was 13.7 ± 12.0% (median 9.3%). The mean number of distal anastomoses of coronary artery bypass was 2.8 ± 1.5. A concomitant mitral procedure was performed in 58.1% of patients. The hospital mortality rate was 11.6% (5 patients). The ejection fraction was improved from 24.1 ± 9.2% to 31.7 ± 8.2% in 2 weeks after surgery. The end-systolic left ventricular volume index was effectively reduced, irrespective of performing a concomitant mitral procedure (reduction rate, ELIET: 35.6% vs ELIET + mitral: 39.2%). After ELIET, the sphericity index of the left ventricle did not worsen, and the conicity index was significantly improved. The 5-year estimated rates of survival and freedom from cardiac events were 71.3 ± 7.9 and 61.1 ± 8.3%, respectively. A concomitant mitral procedure was significantly associated with cardiac events based on univariate Cox hazard analysis. CONCLUSIONS: This study showed that ELIET can effectively reduce the ventricular volume and create an ellipsoidal left ventricle.