Related Experiment Video

Updated: Jun 19, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Primary left ventricular rehabilitation is effective in maintaining two-ventricle physiology in the borderline left

Sitaram M Emani1, Emile A Bacha, Doff B McElhinney

  • 1Children's Hospital Boston, Boston, MA 02115, USA.

The Journal of Thoracic and Cardiovascular Surgery
|October 13, 2009
PubMed

Insights

Left ventricular rehabilitation for borderline left heart disease improves heart function and outcomes. This surgical approach offers an alternative to single-ventricle palliation for complex congenital heart defects.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Cardiac Rehabilitation

Background:

  • Borderline left heart disease involves obstructive lesions and endocardial fibroelastosis, impairing biventricular circulation.
  • Multilevel obstruction and poor left ventricular function are key challenges in these patients.

Purpose of the Study:

  • To evaluate the impact of left ventricular rehabilitation (endocardial fibroelastosis resection with valvuloplasty) on left ventricular function and clinical outcomes.
  • To assess the feasibility of this approach as an alternative to single-ventricle management.

Main Methods:

  • Retrospective analysis of 9 patients with borderline left heart structures and endocardial fibroelastosis undergoing primary left ventricular rehabilitation.
  • Comparison of preoperative and postoperative echocardiogram and cardiac catheterization data, including left heart dimensions and hemodynamics.
  • Paired t-test used for statistical comparison of pre- and postoperative values.

Main Results:

  • No operative mortality observed in the study cohort.
  • Significant improvements in ejection fraction and left ventricular end-diastolic volume post-rehabilitation.
  • Reduced left atrial pressure and right ventricular/left ventricular pressure ratios were noted.

Conclusions:

  • Primary left ventricular rehabilitation improves systolic and diastolic performance in borderline left hearts.
  • This surgical strategy may offer a viable alternative to single-ventricle palliation for selected patients.
  • The procedure leads to decreased right ventricular pressures, enhancing biventricular outcomes.
Abstract

More Related Videos

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart08:49

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

Published on: May 11, 2018

Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure05:18

Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure

Published on: January 16, 2026

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...