{"id":{"repo_id":"freiburg-diss","oai_identifier":"oai:freidok.uni-freiburg.de:1617"},"canonical_url":"https://search.dev.ndltd.org/etd/freiburg-diss/oai:freidok.uni-freiburg.de:1617","repository":{"repo_id":"freiburg-diss","name":"University of Freiburg","base_url":"https://freidok.uni-freiburg.de/oai/oai2.php"},"display":{"title":"Surgical ventricular reconstruction for ischemic or idiopathic dilated cardiomyopathy","abstract":"Background: Any disturbance of the functional cardiac anatomy will impair ventricular function and cardiac output. It has been postulated that the Dor surgical ventricular reconstruction procedure for patients with ventricular dysfunction after an infarction for either left ventricular akinesia or dyskinesia results in better clinical outcome than classic aneurysmectomy or conservative medical therapy. The reason is the focus of this procedure on restoring the physiological dimensions of the remodeled ventricle by excluding noncontracting segments of the heart, including the scarred septum, replacing the area with an endoventricular patch to redirect normal muscle orientation, and reducing ventricular size, wall tension and volume. The theory that this procedure might also be applied to other causes of cardiac remodeling has introduced this application to patients with idiopathic dilated cardiomyopathy (DCM). The purpose of this retrospective study was to analyze the clinical outcome and long-term survival of patients who underwent the Dor surgical ventricular reconstruction (SVR) procedure. <br>Methods: Mortality, cardiac function, and long-term survival were analyzed retrospectively in a cohort of patients with DCM, a ventricular aneurysm, or scar after a myocardial infarction who underwent surgical ventricular reconstruction. <br>Results: The results of this study show an overall 85% three-year survival for patients after the Dor surgical ventricular reconstruction. In-hospital mortality was 4%. Patients who underwent the Dor SVR procedure after postinfarction left ventricular aneurysm demonstrated a survival of 89% at a median follow-up of 19 months (2-36 months). Importantly, patients with associated coronary grafting to the Dor SVR procedure demonstrated a 96% survival rate over a 73% for non-CABG patients. Significant improvement in EF and NYHA functional class was also demonstrated in the ventricular aneurysm group. Patients operated on for left ventricular akinesia had an overall survival of 67% at a median follow-up of 10.5 months (1-20 months) and demonstrated the most impressive improvement in NYHA functional class. The five DCM patients who underwent the Dor surgical reconstruction procedure revealed no long-term benefit from the operation. The efficacy of surgical left ventricular reconstruction is currently being investigated by a multicenter international randomized study funded by the National Institutes of Health. The belief is that patients with a remodeled ventricle as a result of ischemic cardiomyopathy will benefit significantly in clinical outcome and survival when the physiological cardiac anatomy is surgically restored.","abstract_html":"Background: Any disturbance of the functional cardiac anatomy will impair ventricular function and cardiac output. It has been postulated that the Dor surgical ventricular reconstruction procedure for patients with ventricular dysfunction after an infarction for either left ventricular akinesia or dyskinesia results in better clinical outcome than classic aneurysmectomy or conservative medical therapy. The reason is the focus of this procedure on restoring the physiological dimensions of the remodeled ventricle by excluding noncontracting segments of the heart, including the scarred septum, replacing the area with an endoventricular patch to redirect normal muscle orientation, and reducing ventricular size, wall tension and volume. The theory that this procedure might also be applied to other causes of cardiac remodeling has introduced this application to patients with idiopathic dilated cardiomyopathy (DCM). The purpose of this retrospective study was to analyze the clinical outcome and long-term survival of patients who underwent the Dor surgical ventricular reconstruction (SVR) procedure. &lt;br&gt;Methods: Mortality, cardiac function, and long-term survival were analyzed retrospectively in a cohort of patients with DCM, a ventricular aneurysm, or scar after a myocardial infarction who underwent surgical ventricular reconstruction. &lt;br&gt;Results: The results of this study show an overall 85% three-year survival for patients after the Dor surgical ventricular reconstruction. In-hospital mortality was 4%. Patients who underwent the Dor SVR procedure after postinfarction left ventricular aneurysm demonstrated a survival of 89% at a median follow-up of 19 months (2-36 months). Importantly, patients with associated coronary grafting to the Dor SVR procedure demonstrated a 96% survival rate over a 73% for non-CABG patients. Significant improvement in EF and NYHA functional class was also demonstrated in the ventricular aneurysm group. Patients operated on for left ventricular akinesia had an overall survival of 67% at a median follow-up of 10.5 months (1-20 months) and demonstrated the most impressive improvement in NYHA functional class. The five DCM patients who underwent the Dor surgical reconstruction procedure revealed no long-term benefit from the operation. The efficacy of surgical left ventricular reconstruction is currently being investigated by a multicenter international randomized study funded by the National Institutes of Health. The belief is that patients with a remodeled ventricle as a result of ischemic cardiomyopathy will benefit significantly in clinical outcome and survival when the physiological cardiac anatomy is surgically restored.","abstract_has_math":false,"creators":["Ahn-Veelken, Lynda"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Beyersdorf, Friedhelm"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":null,"date_issued":"","date_published":null,"updated_at":"2026-07-24T02:22:22Z","subjects":["Dor-Operation","Remodelling","Batista-Operation","dor operation","Batista operation"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://freidok.uni-freiburg.de/data/1617","outbound_label":"Repository record","outbound_source":"source_url"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Beyersdorf, Friedhelm"]},{"key":"dc:creator","label":"Author","values":["Ahn-Veelken, Lynda"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:type","label":"Dc Type","values":["DoctoralThesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Dor-Operation","Remodelling","Batista-Operation","dor operation","Batista operation"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Any disturbance of the functional cardiac anatomy will impair ventricular function and cardiac output. It has been postulated that the Dor surgical ventricular reconstruction procedure for patients with ventricular dysfunction after an infarction for either left ventricular akinesia or dyskinesia results in better clinical outcome than classic aneurysmectomy or conservative medical therapy. The reason is the focus of this procedure on restoring the physiological dimensions of the remodeled ventricle by excluding noncontracting segments of the heart, including the scarred septum, replacing the area with an endoventricular patch to redirect normal muscle orientation, and reducing ventricular size, wall tension and volume. The theory that this procedure might also be applied to other causes of cardiac remodeling has introduced this application to patients with idiopathic dilated cardiomyopathy (DCM). The purpose of this retrospective study was to analyze the clinical outcome and long-term survival of patients who underwent the Dor surgical ventricular reconstruction (SVR) procedure. <br>Methods: Mortality, cardiac function, and long-term survival were analyzed retrospectively in a cohort of patients with DCM, a ventricular aneurysm, or scar after a myocardial infarction who underwent surgical ventricular reconstruction. <br>Results: The results of this study show an overall 85% three-year survival for patients after the Dor surgical ventricular reconstruction. In-hospital mortality was 4%. Patients who underwent the Dor SVR procedure after postinfarction left ventricular aneurysm demonstrated a survival of 89% at a median follow-up of 19 months (2-36 months). Importantly, patients with associated coronary grafting to the Dor SVR procedure demonstrated a 96% survival rate over a 73% for non-CABG patients. Significant improvement in EF and NYHA functional class was also demonstrated in the ventricular aneurysm group. Patients operated on for left ventricular akinesia had an overall survival of 67% at a median follow-up of 10.5 months (1-20 months) and demonstrated the most impressive improvement in NYHA functional class. The five DCM patients who underwent the Dor surgical reconstruction procedure revealed no long-term benefit from the operation. The efficacy of surgical left ventricular reconstruction is currently being investigated by a multicenter international randomized study funded by the National Institutes of Health. The belief is that patients with a remodeled ventricle as a result of ischemic cardiomyopathy will benefit significantly in clinical outcome and survival when the physiological cardiac anatomy is surgically restored.","Veränderungen der funktionellen Anatomie des Herzens führen zur Beeinträchtigung der ventrikulären Funktion und Verschlechterung des Herzzeitvolumens. Daher wird postuliert, daß Patienten mit ventrikulärer Dysfunktion aufgrund einer linksventrikulären Akinesie oder Dyskinesie infolge eines Herzinfarktes durch die chirurgische Ventrikelrekonstruktion nach V. Dor (Dor SVR) bessere klinische Ergebnisse als bei klassischer Aneurysmektomie oder konservativer Therapie aufweisen. Das Prinzip der Dor-Operation besteht in der Resektion des nicht kontrahierenden Myokardsegmentes mit dem vernarbten Septumanteil und Einnähen eines endoventrikulären Dacron-Patches, um den normalen Muskelfaserverlauf des Ventrikels wiederherzustellen. Hierdurch sollen Grösse, Wandspannung und Volumen des Ventrikels verringert werden, um die physiologische Form des remodellierten Ventrikels zu rekonstruieren. Da dieses Prinzip auch auf andere Ursachen einer kardialen Remodellierung anwendbar sein könnte, ist die Dor SVR auch für die dilatative Kardiomyopathie (DCM) von Interesse. Das Ziel dieser retrospektiven Studie ist die Beurteilung des Erfolges der Dor-Operation hinsichtlich des klinischen Zustandes und Langzeitüberlebens der operierten Patienten. <br>Methoden: Mortalität, Ventrikelfunktion und Langzeitüberleben von Patienten mit dilatativer Kardiomyopathie oder ventrikulärer Dyskinesie bzw. Akinesie nach Myokardinfarkt, die nach Dor operiert worden waren, wurden aus den Krankenakten und mittels Telefoninterview retrospektiv erfasst und ausgewertet. <br>Ergebnisse: Die 3-Jahres-Überlebensrate für Patienten nach der Dor-Operation betrug 85%. Die Krankenhausmortalität lag bei 4%. Nach einer medianen Nachbeobachtungszeit von 19 Monaten (2-36 Monate) hatten Patienten mit einem linksventrikulären Aneurysma nach Herzinfarkt postoperativ eine Überlebensrate von 89%. Patienten, bei denen zusätzlich zur Dor-Operation eine koronare Bypassoperation (CABG) durchgeführt worden war, hatten eine Überlebensrate von 96% im Vergleich zu 73% für Patienten ohne CABG. Eine signifikante Verbesserung der Ejektionsfraktion (EF) und des funktionellen NYHA-Grades durch die Operation wurde bei Patienten mit Ventrikelaneurysma festgestellt. Operierte Patienten mit linksventrikulärer Akinesie hatten eine Überlebensrate von 67% nach einer medianen Beobachtungsdauer von 10,5 Monaten (1-20 Monate) und ebenfalls eine beeindruckende Verbesserung der NYHA-Grades. Für die 5 DCM-Patienten konnte kein Langzeiterfolg der Dor-Operation dokumentiert werden. Obwohl EF, linksventrikulärer enddiastolischer Durchmesser (LVEDD) und die NYHA-Klassifikation als Hauptparameter zur Beurteilung des Erfolges dieses Verfahrens benutzt worden waren, sollte eine kritische Neubewertung der Zuverlässigkeit dieser Parameter vorgenommen werden. Die Wirksamkeit der Dor-Operation wird zur Zeit in einer randomisierten, internationalen Multizenterstudie der National Institutes of Health überprüft."]},{"key":"dc:format.medium","label":"Dc Format Medium","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Surgical ventricular reconstruction for ischemic or idiopathic dilated cardiomyopathy","Chirurgische Ventrikelrekonstruktion für ischämische oder dilatative Kardiomyopathie"]}]}],"canonical_facts":{"dc:contributor":["Beyersdorf, Friedhelm"],"dc:creator":["Ahn-Veelken, Lynda"],"dc:description.abstract":["Background: Any disturbance of the functional cardiac anatomy will impair ventricular function and cardiac output. It has been postulated that the Dor surgical ventricular reconstruction procedure for patients with ventricular dysfunction after an infarction for either left ventricular akinesia or dyskinesia results in better clinical outcome than classic aneurysmectomy or conservative medical therapy. The reason is the focus of this procedure on restoring the physiological dimensions of the remodeled ventricle by excluding noncontracting segments of the heart, including the scarred septum, replacing the area with an endoventricular patch to redirect normal muscle orientation, and reducing ventricular size, wall tension and volume. The theory that this procedure might also be applied to other causes of cardiac remodeling has introduced this application to patients with idiopathic dilated cardiomyopathy (DCM). The purpose of this retrospective study was to analyze the clinical outcome and long-term survival of patients who underwent the Dor surgical ventricular reconstruction (SVR) procedure. <br>Methods: Mortality, cardiac function, and long-term survival were analyzed retrospectively in a cohort of patients with DCM, a ventricular aneurysm, or scar after a myocardial infarction who underwent surgical ventricular reconstruction. <br>Results: The results of this study show an overall 85% three-year survival for patients after the Dor surgical ventricular reconstruction. In-hospital mortality was 4%. Patients who underwent the Dor SVR procedure after postinfarction left ventricular aneurysm demonstrated a survival of 89% at a median follow-up of 19 months (2-36 months). Importantly, patients with associated coronary grafting to the Dor SVR procedure demonstrated a 96% survival rate over a 73% for non-CABG patients. Significant improvement in EF and NYHA functional class was also demonstrated in the ventricular aneurysm group. Patients operated on for left ventricular akinesia had an overall survival of 67% at a median follow-up of 10.5 months (1-20 months) and demonstrated the most impressive improvement in NYHA functional class. The five DCM patients who underwent the Dor surgical reconstruction procedure revealed no long-term benefit from the operation. The efficacy of surgical left ventricular reconstruction is currently being investigated by a multicenter international randomized study funded by the National Institutes of Health. The belief is that patients with a remodeled ventricle as a result of ischemic cardiomyopathy will benefit significantly in clinical outcome and survival when the physiological cardiac anatomy is surgically restored.","Veränderungen der funktionellen Anatomie des Herzens führen zur Beeinträchtigung der ventrikulären Funktion und Verschlechterung des Herzzeitvolumens. Daher wird postuliert, daß Patienten mit ventrikulärer Dysfunktion aufgrund einer linksventrikulären Akinesie oder Dyskinesie infolge eines Herzinfarktes durch die chirurgische Ventrikelrekonstruktion nach V. Dor (Dor SVR) bessere klinische Ergebnisse als bei klassischer Aneurysmektomie oder konservativer Therapie aufweisen. Das Prinzip der Dor-Operation besteht in der Resektion des nicht kontrahierenden Myokardsegmentes mit dem vernarbten Septumanteil und Einnähen eines endoventrikulären Dacron-Patches, um den normalen Muskelfaserverlauf des Ventrikels wiederherzustellen. Hierdurch sollen Grösse, Wandspannung und Volumen des Ventrikels verringert werden, um die physiologische Form des remodellierten Ventrikels zu rekonstruieren. Da dieses Prinzip auch auf andere Ursachen einer kardialen Remodellierung anwendbar sein könnte, ist die Dor SVR auch für die dilatative Kardiomyopathie (DCM) von Interesse. Das Ziel dieser retrospektiven Studie ist die Beurteilung des Erfolges der Dor-Operation hinsichtlich des klinischen Zustandes und Langzeitüberlebens der operierten Patienten. <br>Methoden: Mortalität, Ventrikelfunktion und Langzeitüberleben von Patienten mit dilatativer Kardiomyopathie oder ventrikulärer Dyskinesie bzw. Akinesie nach Myokardinfarkt, die nach Dor operiert worden waren, wurden aus den Krankenakten und mittels Telefoninterview retrospektiv erfasst und ausgewertet. <br>Ergebnisse: Die 3-Jahres-Überlebensrate für Patienten nach der Dor-Operation betrug 85%. Die Krankenhausmortalität lag bei 4%. Nach einer medianen Nachbeobachtungszeit von 19 Monaten (2-36 Monate) hatten Patienten mit einem linksventrikulären Aneurysma nach Herzinfarkt postoperativ eine Überlebensrate von 89%. Patienten, bei denen zusätzlich zur Dor-Operation eine koronare Bypassoperation (CABG) durchgeführt worden war, hatten eine Überlebensrate von 96% im Vergleich zu 73% für Patienten ohne CABG. Eine signifikante Verbesserung der Ejektionsfraktion (EF) und des funktionellen NYHA-Grades durch die Operation wurde bei Patienten mit Ventrikelaneurysma festgestellt. Operierte Patienten mit linksventrikulärer Akinesie hatten eine Überlebensrate von 67% nach einer medianen Beobachtungsdauer von 10,5 Monaten (1-20 Monate) und ebenfalls eine beeindruckende Verbesserung der NYHA-Grades. Für die 5 DCM-Patienten konnte kein Langzeiterfolg der Dor-Operation dokumentiert werden. Obwohl EF, linksventrikulärer enddiastolischer Durchmesser (LVEDD) und die NYHA-Klassifikation als Hauptparameter zur Beurteilung des Erfolges dieses Verfahrens benutzt worden waren, sollte eine kritische Neubewertung der Zuverlässigkeit dieser Parameter vorgenommen werden. Die Wirksamkeit der Dor-Operation wird zur Zeit in einer randomisierten, internationalen Multizenterstudie der National Institutes of Health überprüft."],"dc:format.medium":["application/pdf"],"dc:subject":["Dor-Operation","Remodelling","Batista-Operation","dor operation","Batista operation"],"dc:title":["Surgical ventricular reconstruction for ischemic or idiopathic dilated cardiomyopathy","Chirurgische Ventrikelrekonstruktion für ischämische oder dilatative Kardiomyopathie"],"dc:type":["DoctoralThesis"]},"updated_at":"2026-07-24T02:22:22Z"}