Author + information
- Giuseppe Nasso,
- Raffaele Bonifazi,
- Vito Romano,
- Felice Piancone,
- Giuseppe Visicchio and
- Giuseppe Speziale
We conducted a prospective study of the clinical outcomes and health-related quality-of-life after implantation of the CorCap cardiac support device (Acorn Cardiovascular Inc.) for dilated cardiomyopathy.
The CorCap was implanted in case of dilated cardiomyopathy (left ventricular end-diastolic diameter >60 mm. and <80 mm., left ventricular ejectionfraction <30%), symptoms of heart failure (NYHA class III or IV) despite maximal medical therapy, and good renal, pulmonary and hepatic functions. Echocardiographic follow-up and evaluation with the SF-36 questionnaire were performed. An average 25.1 ± 4.3 follow-up was available.
Forty patients were included. A statistically significant improvement was evident in mean left ventricular ejection fraction, end-diastolic diameter, end-diastolic volume and volume index, end systolic diameter, end-systolic volume and volume index, left ventricular sphericity index at the last follow-up vs. baseline. The cumulative mortality was 10% (no follow-up deaths after the 1st postoperative year). The average physical health domain scores (physical functioning, role physical, general health) were statistically improved. Average mental health domain scores were also increased. Concomitant mitral surgery and cardiac resynchronization therapy did not appear to significantly improve the clinical results. Cox regression evidenced lesser improvement in quality-of-life domains among patients with ischemic cardiomyopathy.
The cardiac support device obtains reverse remodelling of the left ventricle, and allows stable improvement in the quality of life until to the 2nd year post-implantation. The integration of different and complementary strategies (cardiac support device, resynchronization therapy and aggressive treatment of functional mitral regurgitation) may represent the key of success for the more complex patients.
- 2013 American College of Cardiology Foundation