1552, either, cat: 54
CLINICAL OUTCOME OF MANNEQUIN GUIDED SURGICAL
VENTRICULAR RESTORATION (TRISVR): DATA FROM AN
INTERNATIONAL REGISTRY ENROLLING PATIENTS UNDERGOING A
STANDARDIZED PROCEDURE
M. Di Donato1 , S Boyce2, R Hebeler3, T Acuff4, S Szenpetery5, D Smull6, M Mack7,
L Menicanti1
1
San Donato Hospital, Milano, Italy, 2Washington Hospital Center, Washington DC,
USA, 3Baylor Hospital Center, Dallas, Texas, USA, 4Denton Regional Hospital, Denton,
Texas, USA, 5Sentara Norfolk Medical Center, Richmond, Virginia, USA, 6Fosyth
Medical Center, Winston-Salem, North Carolina, USA, 7Medical City Hospital, Dallas,
Texas, USA
Surgical Ventricular Restoration (SVR) is treatment for post-infarction heart failure pts
with dilated cardiomyopathy. Recent refinements to SVR is the TRISVR approach (size
,shape and orientation) using the endoventricular shaper (Chase Medical) to standardize
the procedure. Preliminary data of an international registry tracks pts submitted to SVR
with the TRISVR endoventricular shaping device. 261 pts with previous anterior MI
(64±10 years, 17%F) have been enrolled. Mannequin was filled at 50 to 60 ml/m2 to size
and re-shape the residual cavity; 95% received concomitant CABG; 14% had mitral
repair. 50% were in NYHA class III/IV, preoperatively. 55% were elective and 45%
urgent. Mean EF was 31±9% (<30% in 43%; <20% in 8%). Mean diastolic diameter was
63±10 mm (>/=70 in 23%). Pts with a preoperative EF >20% (n=148) demonstrate a 30
day operative mortality of 4% and pts with an EF < = 20% a 9.1% (n=22) mortality in the
group with no MVR procedure. Overall cardiac mortality was 7.3%. ANOVA showed
that mortality was associated with larger end diastolic and end systolic volumes (254±94
vs 194±65 and 196±86 vs 134±58 ml, - p0.010); lower EF (22±6 vs 32±8%-p0.001);
thinner diastolic thickness (8.8±2.2 vs 11.1±2.7 mm-p 0.03) and higher pulmonary
pressure (41±14 vs 31±10 mmHg –p 0.03). Average NYHA class improved from 2.5±0.6
to 1.7±06. Conclusion: this is the first international registry describing a standardized
SVR procedure.
Pre
Post Change (%) p-valueEDV (ml)
198±68
134±41
-64 (-32%)
0.0001ESV(ml)
138±62
83±32 -55 (40%) 0.0001EF (%) 31±8 39±9 +8
0.0001