Author/Editor		Radovanović, Ninoslav; Petrović, Ljuborad; Mihajlović, Bogoljub; Kovač, Marko; Lavač, Jožef; Kovačević, Pavle; Mijatov, Milan; Popović, Snežana; Torbica, Vladimir; Zorc, Marijeta
Title		Surgical therapy for heart failure, RADO operation - personal experience
Type		članek
Source		In: Štiblar-Martinčič D, Petrovič D, editors. Cardiovascular diseases. Proceedings of the 32nd memorial meeting devoted to professor Janez Plečnik, International symposium in memory of professor Rene Favaloro; 2001 Dec 6-8; Ljubljana. Ljubljana: Medical faculty,
Publication year		2001
Volume		str. 85-103
Language		eng
Abstract		Patients with dilated cardiomyopathy (DCM) represent a huge remodeling of the fibrous skeleton of the heart with mitral and tricuspid annulus dilatation and consecutive mitral and tricuspid regurgitation. Remodeling of the fibrous skeleton of the base of the heart is an important part of remodeling of the left ventricle. Medical treatment of these patients is not successful. The aim of this study is to show hemodynamic and clinical improvement after Reductive Annuloplasty of Double (mitral and tricuspid) Orifices (RADO) in ischemic dilated cardiomyopathy (IDCM) and primary dilated cardiomyopathy (PDCM). There were 290 patients (253 males, 37 females), mean age 52.8 years, 202 pts (70%) operated due to IDCM with ejection fraction (EF) under 30% and 88 pts (30%) due to PDCM. Out 290 pts, 70% were in NYHA class IV and 75% had previous cardiac decompensation. The mean ejection fraction was 22.6%. Mean value of left ventricular diastolic internal diameter (LVIDd) in IDCM was 7.0 cm and in PDCM was 7.3 cm. Mean value of mitral annulus area (MAA) in IDCM was 9.0 cmz and in PDCM was 8.6 cm2. Mitral annuloplasty according to A. Carpentier and our own procedure were done in 42 and 248 pts, respectively. In 271 (93%) cases our modified De Vega's tricuspid annuloplasty was performed. Myocardial revascularisation was done in all 202 pts with IDCM. The analysis of hemodynamic parameters, using Swan-Ganz catheter and thermodilution method, was made in the period prior to the surgical intervention, before extracorporeal circulation (ECC) and after the correction of mitral and tricuspid regurgitation (immediately after ECC, 24 and 42 hours from ECC). The results show statistically signofocant improvement (p<0.01) after operation. (Abstract truncated at 2000 characters).
Descriptors		HEART FAILURE, CONGESTIVE CARDIAC OUTPUT ECHOCARDIOGRAPHY, TRANSESOPHAGEAL POSTOPERATIVE COMPLICATIONS SURVIVAL ANALYSIS HEART VALVE DISEASES