Ventricular reconstruction or aneurysm repair using a modified linear repair technique with septal patch when indicated.

A presentation of our approach for ventricular reconstruction or aneurysm resection which includes a modified linear closure plus septal patch technique when indicated. Our philosophy regarding reconstruction combined with coronary artery bypass grafting (CABG) versus revascularization alone is reviewed. When reconstruction is indicated, the surgical approach is planned on the basis of information gained from preoperative angiography and study of ventricular anatomy as defined by magnetic resonance imaging (MRI).

Left ventricular reconstruction: Early and late results.

Objectives: In patients with coronary disease and poor left ventricular function, ventricular reconstruction with revascularization is a surgical option. Details of patient selection and optimal surgical technique are still debated. This study reports results achieved with ventricular reconstruction in 285 patients who had akinesia or dyskinesia associated with relative wall thinning.

Gender differences in quality of distal vessels: effect on results of coronary artery bypass grafting.

Objective: The quality of target vessels may affect gender differences in outcome after coronary artery bypass grafting. This prospective study compares preoperative angiographic assessment of vessel quality with intraoperative visual assessment of size and presence or absence of diffuse disease. The effect of vessel quality on operative mortality and late survival is examined.

Mild to moderate mitral regurgitation in patients undergoing coronary bypass grafting: effects on operative mortality and long-term significance.

Background: Patients undergoing bypass grafting (CABG) often present with mitral regurgitation (MR). While surgical strategy for patients with either trace or severe MR is well established, the need for a valve procedure with mild (2) to moderate (3+) mitral regurgitation is controversial.

Methods: We reviewed 1,939 consecutive CABG patients (1987 to 1999).

Ventricular reconstruction for ischemic cardiomyopathy.

Left ventricular surgical reconstruction has been advocated for patients with coronary artery disease, prior myocardial infarction, and poor left ventricular function. The objective of the approach is to resect or exclude all akinetic or dyskinetic nonfunctioning portions of the ventricular cavity and to restore the left ventricle size and shape toward normal as much as possible. We review the pathophysiology of ischemic cardiomyopathy and suggest guidelines for preoperative assessment and patient selection for ventricular reconstruction.

Positron emission tomography and recovery following revascularization (PARR-1): the importance of scar and the development of a prediction rule for the degree of recovery of left ventricular function.

Objectives: The aim of this study was to determine whether the extent of viability or scar is important in the amount of recovery of left ventricular (LV) function, and to develop a model for predicting recovery after revascularization that could be tested in a randomized trial.

Background: F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) is used to define viable myocardium in patients with coronary artery disease (CAD) and severe LV dysfunction and to guide revascularization decisions. Whether this approach improves clinical outcomes has not been tested in a randomized trial.

Left ventricular reconstruction for ischemic cardiomyopathy.

An outline of the Toronto General Hospital's philosophy for revascularization and left ventricular reconstruction in patients with ischemic cardiomyopathy. An open beating heart technique with modified linear closure and septoplasty when indicated is used for repair of both akinetic and dyskinetic scar. Patient selection, OR mortality (2.