Myocardial reconstruction in ischaemic cardiomyopathy

Eur J Cardiothorac Surg. 2019 Jun 1;55(Suppl 1):i49-i56. doi: 10.1093/ejcts/ezy367.

Abstract

An increase in left ventricular volume after a myocardial infarction is a key component of the adverse remodelling process leading to chamber dysfunction, heart failure and an unfavourable outcome. Hence, the therapeutic strategies have been designed to reverse the remodelling process by medical therapy, devices or surgical strategies. Surgical ventricular reconstruction primarily combined with myocardial revascularization has been introduced as an optional intervention aimed to reduce the left ventricle through resection of the scar tissue and is recommended in selected patients with predominant heart failure symptoms, and with myocardial scarring and moderate left ventricular remodelling. This review outlines the rationale and the technique for reconstructing the left ventricle and the possible indications for using that technique, based on experiences from the centre with the largest international experience. The major contributions in the literature are briefly discussed.

Keywords: Heart failure; Left ventricular remodelling; Surgical ventricular reconstruction.

Publication types

  • Review

MeSH terms

  • Biomarkers / blood
  • Cardiomyopathies / surgery*
  • Contraindications, Procedure
  • Heart Ventricles / surgery*
  • Humans
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency / surgery
  • Myocardial Ischemia / surgery*
  • Natriuretic Peptide, Brain / blood
  • Patient Selection
  • Peptide Fragments / blood
  • Ventricular Remodeling*

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain