**6. References**

72 Front Lines of Thoracic Surgery

Compare outcomes and examine relationships between depression and geographic status following CABG surgery

Examine relationship between depression and PTSD on outcomes following CABG surgery

Examine the efficacy of a brief CBT for pts prior to CABG surgery

Examine the efficacy of HRV biofeedback treatment for patients with PTSD prior to CABG surgery

Examine the effect of and anxiety and gender on outcomes following CABG surgery

Table 1. Review of Research Reporting Predictors of Outcomes Following Coronary Artery

**Primary Outcome Result** 

Rural pts were more likely than urban pts to have a depression

Depression was a predictor of mortality and length of stay following CABG surgery Rural pts had increased lengths of hospital stays and increased mortality rates when compared to urban pts

Depression and PTSD were prevalent in pts undergoing CABG

Depression and PTSD (and in combination) increased the risk of mortality as well as physical health risk factors following CABG surgery

The intervention improved depressive and anxiety symptoms and quality of life and reduced length of hospital stay

HRV biofeedback training results in improvement in PTSD symptoms in patients undergoing CABG surgery, improves the quality of life, and decreases the length of hospital stay

Anxiety disorders are prevalent in rural patients who are undergoing a

independent predictor of both length of hospital stay and non-routine discharge for patients receiving

Females with an anxiety disorder seemed to have more aversive outcomes than males with an anxiety

CABG operation Anxiety was a significant

CABG surgery

disorder

diagnosis

surgery

**Author Year Sample** 

**Size** 

Dao 2010b 63,061 Pts who

Dao 2010c 62,665 Pts who

Dao 2011a 100 Pts who were

Dao 2011c 17,885 Rural pts who

Bypass Grafting Surgery (continuation)

Dao 2011b 65 Pts who

**Sample Characteristics**

underwent CABG surgery

underwent CABG surgery

scheduled for CABG surgery

underwent CABG surgery

underwent CABG surgery


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**5** 

*Japan* 

**Surgical Ventricular Restoration for** 

Masanori Hirota, Shintaro Katahira, Joji Hoshino, Yasuhisa Fukada, Taichi Kondo, Takayuki Gyoten, Yuichi Notomi and Tadashi Isomura

Ischemic cardiomyopathy (ICM) is defined as diffuse akinesis of the ventricle after myocardial ischemia1). A subset of patients with ICM develop progressive heart failure as a consequence of adverse left ventricular (LV) remodeling, leading to a depressed ejection fraction, a dilated LV, a large akinetic region of the myocardium, an abnormal globular shape to the ventricular chamber, and functional mitral regurgitation (MR)2-5). Although a dilated LV with poor cardiac function is a risk by itself, coexisting functional MR worsens the prognosis of ICM6,7). Thus, for patients with ICM and functional MR, it is very important to repair the geometric changes of LV remodeling and to decrease the extent of functional

For patients with ICM, surgical ventricular restoration (SVR) is an established treatment to reduce ventricular size and restore the elliptical shape of the LV8-12). Anatomical restoration by SVR may decrease the severity of MR, through various mechanisms, including reduction of ventricular dimensions, lowering of end systolic volumes, and restoration of blood flow to the ischemic region of the mitral subvalvular apparatus13,14). However, concomitant procedures for the mitral valve are required for further reduction of functional MR. In this chapter, our therapeutic strategy for patients with ICM is demonstrated, and we describe

Between May 2000 and May 2010, SVR was performed in 335 patients with ICM (n=199) and non-ischemic cardiomyopathy (n=136). Of the 199 patients with ICM, 88 had concomitant

These patients with ICM and functional MR included 77 males and 11 females, ranging in age from 32 to 83 years (mean, 61±10 years). The preoperative New York Heart Association (NYHA) functional class was class III for 55% (48/88) and class IV for 45% (40/88). Preoperative heart failure was medically controlled with inotropes in 34 patients (39%), and 2 of these patients (2%) required intra-aortic balloon pumping (IABP). Due to uncontrollable

the details of the surgical techniques of SVR and mitral valve surgery.

**1. Introduction** 

MR.

**2. Patients** 

mitral valve surgery for functional MR.

*Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa,* 

**Ischemic Cardiomyopathy with** 

 **Functional Mitral Regurgitation** 

