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. Pdf ventricular restoration by linear endoventricular. Early results after surgical treatment of left ventricular. Aneurysm repair techniques have evolved to geometric repair by exclusion of the aneurysmal area with a circular patch. Doublepatch repair of postinfarction ventricular septal. The dor procedures, also called endoventricular circular patch plasty or evcpp, are used when a widening aneurysm forms in the ventricle following a heart attack. 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. The aim of this method is to rebuild the left ventricular geometry after myocardial infarction akineticdyskinetic zone aneurysm, making the cavity helical again. The patient underwent surgery where left ventricular volume reduction using endoventricular circular patch plasty evcpp and mitral valve replacement mvr were performed. Left ventricular lv pump function improvement is difficult to predict after aneurysmectomy, for either. Iliac and femoral endarterectomy and patch plasty why do i need an operation. Department of cardiovascular surgery of mc erebouni first time in armenia began to carry out cardiac surgery forpostinfarction heart aneurysm. 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. In 1985, dor introduced evcpp as a viable method for restoring a dilated left ventricle lv to its normal, elliptical geometry.
You have had a scan of your leg arteries to assess the blood flowing through them. The procedure involves placement of a circular synthetic or autologous. A 17year experience vincent dor marisa di donato michel saba tier franfoise montiglio filippo civaia and the restore group the first experience with endoventricular circular patch plasty evcpp was reported in 1984 as a. Endoventricular patch plasty can improve lv function.
We present here a case of endstage nonischemic valvular dilated cardiomyopathy dcm associated with mitral regurgitation mr. Impact of surgical ventricular restoration on early and long. Jan 26, 2015 endoventricular circular patch plasty dor operation. Scarred lv wall can be dyskinetic or akinetic according to the type of infarction transmural or not, and the progressive dilatation of lv remodeling depends on the size of the. Postinfarction ventricular septal perforation repair with endoventricular circular patch plasty using double patches and gelatinresorcinolformaldehyde biological glue. 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. The left ventricular reconstruction lvr with endoventricular circular patch plasty evcpp was reported in 1984 as a surgical method to rebuild left ventricular aneurysm or asynergy after myocardial infarction. 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. The endoventricular circular patch plasty dor procedure. Left ventricular volume and function after endoventricular. Left ventricular aneurysm and pseudoaneurysm following. The dor procedure, which uses a circular suture and a dacron patch to correct lv aneurysms and exclude scarred parts of the septum and ventricular.
The evcpp enabled surgeons to completely exclude the scar area, including the septum, and yet maintain lv geometry with a patch. Modified endoventricular circular plasty dor procedure ctsnet. Modified endoventricular circular plasty dor procedure. The endoventricular circular patch plasty repair was reported in 1984 by vincent dor 1, 2, and 3. This video demonstrates two cases of left ventricular circular patch plasty dor operation for large. But even circular endoventricular patchplasty may result in a less elliptical. Pdf akinetic versus dyskinetic postinfarction scar. 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.
In anterior infarction, the free lv wall and septum are scarred and become dyskinetic or akinetic. Left ventricular aneurysm resection and remodeling dor. Surgical treatment of congestive heart failure gregoric. Relation to surgical outcome in patients undergoing endoventricular circular patch plasty repair. Mitral valve repair with decalcification of the annulus and pericardial patch repair. Endoventricular circular patch plasty dor operation. We tested the hypotheses that the dor procedure increases systolic circumferential shortening and longitudinal shortening in noninfarcted left ventricular regions in sheep. There were 8 men and 2 women with age range of 47 to 71 years. 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. We analyze the efficacy of two techniques, linear vs. Jun 01, 2001 abstract we describe a technique for repairing the ventricular septal perforation 10 days post acute anteroseptal myocardial infarction using the modified infarction exclusion method.
Endoventricular circular patch plasty for endstage. 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. Pre and postoperative 1, 2, 6, and 12month clinical outcomes of the patients mean. The objective of the present investigation was to evaluate. Surgical management of left ventricular aneurysms by the. Method and device for percutaneous surgical ventricular repair. Dor procedure definition of dor procedure by medical dictionary. May 09, 2017 left ventricular reconstruction was performed with endoventricular circular patch plasty evcpp dor procedure or linear repair technique.
Jul 24, 2017 endoventricular patch plasty by dr janardhana reddy d chennai, india. Surgical management of left ventricular aneurysms by the endoventricular circular patch plasty technique vincent dor in 1958, cooley resected a left ventricular aneurysm lva while using cardiopulmonary bypass to sustain the systemic circulation, thereby ushering in the mod ern era of surgery for left ventricular aneurysms. Preoperative and late postoperative mitral regurgitation. Prates, abud homsi neto, lucas maynard lovato, guaracy f.
Sunamoripostinfarction ventricular septal perforation repair with endoventricular circular patch plasty using double patches and gelatinresorcinolformaldehyde biological glue. An appropriate boundary for endoventricular circular patch repair figure, a was defined between nonviable and healthy myocardium. This study included 62 patients who underwent svr from 1086 consecutive patients were subjected to cabg between 2000 and 2009, by the plication in 1, by the liner repair in 26 41. The dor procedure of surgical ventricular reconstruction. Doublepatch technique for postinfarction ventricular septal. Initial effects of the left ventricular repair by plication. It is also known as endoventricular circular patch plasty evcpp. Left ventricular reconstructive surgery mclaren health care. Controversy still exists regarding the optimal surgical technique for lva repair. The first experience with endoventricular circular patch plasty evcpp was. This study evaluates clinical and hemodynamic results of endoventricular circular patch plasty in patients with either large akinetic scar n 51 or large. Ventricular restoration by endoventricular patch plasty. Late results of endoventricular patch plasty repair in akinetic and dyskinetic areas after acute myocardial infarction. Endoventricular patch plasty dor procedure has gained favor as a surgical treatment for heart failure associated with large anteroapical myocardial infarction.
The procedures were conducted under cardiopulmonary bypass or offpump beating heart for the aneurysm repair and for the revascularization. Left ventricular restoration for ischemic cardiomyopathy. 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. Endoventricular patch plasty was introduced as a more physiologic repair than the linear closure technique, especially when the aneurysm extends into the septum.
Ventricular septal defect closure and dor procedure ctsnet. Both morphology and hemodynamic of left ventricle, are improved. Endoventricular circular patch plasty dor operation vumedi. 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 have repaired both akinetic and aneurysmal dyskinetic segments with endoventricular circular patch plasty evcpp. This was the most common procedure for this indication until the late 1980s, when vincent dor and his colleagues introduced endoventricular patch plasty evpp. The surgical technique of linear endoventricular patch plasty. We describe a technique for repairing the ventricular septal perforation 10 days post acute anteroseptal myocardial infarction using the modified infarction exclusion method.
In the surgery, a looped stitch is created to shrink the area of dead, scarred tissue where the aneurysm formed. Dor, or modified dor, procedure to credit vincent dor, md, who authored many articles on the. Overall 5year cumulative survival was higher after endoventricular patch plasty fig. Braz j cardiovasc surg application of circular patch plasty. The consequence is dilated ischemic cardiomyopathy. Dor procedure definition of dor procedure by medical. Di donato m, sabatier m, dor v, toso a, maioli m, fantini f. From 1984 to 2000, 950 left ventricular ischemic asynergy dyskinetic or akinetic were operated using the endoventricular circular patch plasty technique. Mitral valve repair with decalcification of the annulus and pericardial patch. Endoventricular circular patch plasty repair dor, or modified dor, procedure to credit vincent dor, md, who authored many articles on the procedure he began.
A vent was positioned through the pulmonary vein into the lv cavity. Dor operation endoventricular circular patch plasty. 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. Ventricular reconstruction was performed using endoventricular circular patch plasty dor procedure n48. A 17year experience, seminars in thoracic and cardiovascular surgery, 4, 435, 2001. Surgical ventricular restoration modified dor procedure. This allows to exclude all asynergic areas of the left ventricular wall and reshape the remaining wall.
Dor procedure or the endoventricular circular patch plasty evccp, is an operation, introduced by vincent dor, in 1985. Dor operation endoventricular circular patch plasty youtube. Application of circular patch plasty dor procedure or linear. A new lv chamber was thereafter created, using an ovalshaped dacron patch as described by dor 4 figure, b. Left ventricular reconstructive surgery modified dor. We introduce a new operative procedure of infarct exclusion with polytetrafluroethylene ptfe patch and closure of ventriculotomy without pledged or felt. During the study period, svr was performed using the plication repair technique in 34 33. Left ventricular reconstruction by endoventricular circular. The dor procedure is a medical technique used as part of heart surgery and originally introduced by the french cardiac surgeon vincent dor b. Left ventricular reconstruction by endoventricular circular patch plasty repair. Application of circular patch plasty dor procedure or.
The endoventricular circular patch plasty dor procedure in. A new surgical technique advocated by dor et al, 4 called endoventricular circular patch plasty technique evcpp, has been widely accepted. Postinfarction ventricular septal perforation repair with. Left ventricular reconstructive surgery modified dor procedure. Left ventricular reconstruction by endoventricular circular patch. Dor operation endoventricular circular patch plasty video. Dor v, saab m, coste p, kornaszewska m, montiglio i.
This has confirmed that one or more of the main arteries that carries blood to your leg is blocked in the region of your groin, meaning that the blood flow to the leg is reduced. The procedure itself is a viable method of restoring a dilated left ventricle to its normal eliptical geometry. Combined surgical left ventricular reconstruction and left. The procedure of lv restoration was selected pre and intraoperative examination and endoventricular circular patch plasty was performed in 76, partial left ventricle resection in three, and sepal anterior exclusion in. Late results of endoventricular patch plasty repair in. Dor and associates 27 first described the technique of endoventricular circular patch plasty evcpp, which is used to treat patients with postinfarction left ventricular scarring. Many believe that dyskinesia is the only predictor of favorable surgical outcome after large myocardial infarction and that akinetic scars do not recover well in patients with globally depressed ventricular function.
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. Left ventricular reconstruction by endoventricular. Left ventricular reconstruction was performed with endoventricular circular patch plasty evcpp dor procedure or linear repair technique. Its use in a patient resulted in an almost normal shaped continue reading. Left ventricular shape changes induced by aneurysmectomy with endoventricular circular patch plasty reconstruction. Endoventricular circular patch plasty dor operation ctsnet. Few modifications in his technique of simple resection and. Left ventricular aneurysm lva is a serious complication of myocardial infarction and reduces the chances of survival. The endoventricular circular patch plasty dor procedure in ischemic akinetic dilated ventricles. Nov 27, 2017 dor v, montiglio f, sabatier m, et al. In small aneurysms not involving the septum, the theoretical advantages of evpp are less convincing. Surgical repair of a postinfarct ventricular septal rupture vsr remains a difficult surgical challenge associated with a significant operative mortality. Impact of surgical ventricular restoration on early and. Dor procedure university of medicine and dentistry of new.
Surgical repair of lva was first performed by charles bailey in 1954. Nov 21, 2012 left ventricular aneurysm lva is a serious complication of myocardial infarction and reduces the chances of survival. Didonato m, sabatier m, dor v, toso a, maioli m, fantini f. 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.
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