Methods: Between April 2006 and March 2015, 18 patients with dyskinetic (dyskinetic group) and 12 patients with akinetic (akinetic group) postinfarction LV anterior aneurysm receiving SVR with the Dor procedure at Chinese People's Liberation Army General Hospital were enrolled in this study.
Surgical ventricular restoration (SVR) with different techniques has been performed to treat LV aneurysm.[sup],,,, In 1985, Dor introduced an original surgical technique, endoventricular circular patch plasty repair (the Dor procedure), to improve geometric reconstruction with respect to standard linear repair in LV aneurysm.[sup], A marked improvement in LV volume and pump function early after SVR with the Dor procedure has been reported in patients with postinfarction LV anterior aneurysm.[sup] However, there is limited detailed analysis of changes in LV shape at the apical level.
A retrospective analysis was carried out on patients who underwent SVR with the Dor procedure, using data from the echocardiography database of the Department of Cardiovascular Surgery of Chinese PLA General Hospital.
For the Dor procedure, the rebuilding of the LV cavity is initiated using a continuous suture placed at the junction of the scar and normal myocardium, and the suture is tightened at the theoretical diastolic capacity of the patient LV (50–60 ml/m [sup]2) to attain a normal size of the LV.[sup] In addition, this endoventricular circular suture may restore the curvature of the myocardium to what it was before the infarct.
The Dor procedure for the repair of aneurysm depends on the identification of the junction between scar and normal myocardium,[sup] which is not always definitive and cannot be detected easily in patients with akinetic aneurysm,[sup] and therefore an excess of scarred LV may be salvaged; or (2) progressive LV remodeling.
from The Karolinska group in Stockholm presented 53 patients who underwent the Dor procedure with nonelectrophysiologically guided subtotal endocardectomy and cryoablation for VT at the transition zone of the scar and viable tissue.
Lindblom, "Surgery for ventricular tachycardia in patients undergoing left ventricular reconstruction by the Dor procedure," The Annals of Thoracic Surgery, vol.
She underwent emergent coronary artery bypass grafting (the saphenous vein was used to bypass the left anterior descending artery) and the repair of the left ventricular apical aneurysm by the endoventricular circular patch plasty technique (Dor procedure
) with a bovine pericardium (Periguard[R], Bio-Vascular, Inc, St Paul, MN, USA) in our center.
Recently, many articles attested to the superiority of adding either a Toupet or a Dor procedure to the myotomy.
However, recent studies have indicated that a Heller myotomy and Dor procedure should be the treatment of choice for achalasia (14,17,27) because it is associated with good relief of dysphagia and a low rate of GOR as determined by 24-hour pH monitoring.