[Dor's operation (endoventricular circular patch plasty)].

Abstract

Endoventricular circular patch plasty (EVCPP; Dor's operation) for akinesis or dyskinesis in patients with ischemic heart disease may improve the cardiac function and prognosis. In this paper, the operative results are reviewed based on the reports in the literature and the author's experience. EVCPP was performed in patients with large dyskinesis and global akinesis. The akinetic left ventricular wall was excluded with an oval patch and the left ventricle was restored. In Dor's report, 49 patients with akinesis underwent EVCPP with a 10% mortality rate, and left ventricular function improved after surgery. The ejection fraction (EF) improved from 23% to 38% and end-diastolic volume index (EDVI) improved from 248 ml/m2 to 107 ml/m2. Recently, it was reported that the 8-year survival rate in 59 patients with akinesis was similar to that in 49 patients with large dyskinesis. In the author's experience there were 10 hospital deaths in 81 patients with akinesis, and 17 patients died in the late follow-up period, while 53 patients were in NYHA class I or II after surgery. The EF improved from 24% to 36% and the EDVI improved from 153 ml/m2 to 103 ml/m2. The EVCPP is effective in patients with ischemic cardiomyopathy to improve postoperative cardiac function and prognosis.