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Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
Published on: April 8, 2013
Left ventricular volume reduction surgery for heart failure: a physiologic perspective
J H Artrip1, M C Oz, D Burkhoff
1Department of Surgery, Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
The Journal of Thoracic and Cardiovascular Surgery
|October 3, 2001
Summary
Ventricular volume reduction surgery outcomes depend on the type of tissue removed. Resecting dyskinetic scar tissue improves heart function, while removing contracting muscle impairs it.
Area of Science:
- Cardiovascular Surgery
- Cardiac Mechanics
- Biomedical Engineering
Background:
- Ventricular volume reduction surgery for idiopathic cardiomyopathy yields poor results.
- Surgery after myocardial infarction shows better outcomes, but reasons are unclear.
Purpose of the Study:
- To predict the hemodynamic effects of different ventricular volume reduction surgical approaches.
- To elucidate the impact of resecting various myocardial tissue types on cardiac function.
Main Methods:
- A composite left ventricular model was used to simulate volume reduction surgery.
- Simulations involved resecting 20% of myocardium with properties of weak muscle, akinetic scar, or dyskinetic scar.
- End-systolic and end-diastolic pressure-volume relationships were numerically determined.
Main Results:
- All volume reduction procedures reduced chamber size, shifting pressure-volume relationships leftward.
- Resecting dyskinetic scar favorably impacted overall pump function.
- Resecting contracting muscle negatively affected pump function, while akinetic scar had equivocal effects.
Conclusions:
- The impact of ventricular volume reduction surgery on pumping characteristics is dictated by the specific material properties of the resected myocardial region.
- Differential effects on end-systolic and end-diastolic properties determine surgical outcomes.
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