A single center’s experience with total arterial revascularization and spiral aneurysmorrhaphy for ischemic cardiac disease

• Published in: Heart and vessels 2019-06, Vol.34 (6), p.906-915
• Main Authors: Doulamis, Ilias P., Perrea, Despina N., Mastrokostopoulos, George, Drakopoulou, Konstantina, Voutetakis, Konstantinos, Tzani, Aspasia, Chloroyiannis, Ioannis A.
• Format: Article
• Language: English
• Subjects: Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Medicine; Medicine & Public Health; Original Article; Vascular Surgery
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-018-1317-z

The restoration of left ventricular (LV) geometry in combination with coronary artery bypass grafting for the treatment of ischemic cardiac disease remains controversial. We hereby present the experience of our center with total arterial myocardial revascularization (TAMR) and spiral aneurysmorrhaphy for ischemic heart disease. A retrospective analysis of 101 patients with advanced cardiovascular disease who underwent TAMR and spiral aneurysmorrhaphy was performed. Spiral aneurysmorrhaphy is a modification of the linear aneurysmorrhaphy and was applied to patients who had a LV aneurysm with a diameter of less than 5 cm. Peri-operative and in-hospital data were retrieved. The majority of the patients were male (87.13%) with a mean age of 63.1 years. Mean pre-operative ejection fraction (EF) was 35.7% ranging between 20 and 65%. An average of 3.23 grafts was required per patient. Early mortality was 6.93% (one intra-operative and six in-hospital deaths). Addition of concomitant valve surgery was associated with prolonged total operative, cardiopulmonary bypass and cross-clamp time ( p