Posterior ventricular restoration treatment for heart failure: a review, past, present and future aspects

Congestive heart failure (CHF) is one of the major causes of death and occurs in more than 15,000,000 patients worldwide. The incidence is expected to increase in parallel with the aging population. Most current therapies for CHF are medications, and biventricular pacing implantation as appropriated...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2017-03, Vol.65 (3), p.137-143
Main Authors: Isomura, Tadashi, Fukada, Yasuhisa, Miyazaki, Takuya, Yoshida, Minoru, Morisaki, Akimasa, Endo, Masahiro
Format: Article
Language:English
Subjects:
Animals
Cardiac Surgery
Cardiac Surgical Procedures - methods
Cardiology
Cardiomyopathy
Current Topics Review Article
Heart failure
Heart Failure - surgery
Heart Transplantation
Heart transplants
Heart Ventricles - surgery
Heart-Assist Devices
Humans
Ischemia
Medicine
Medicine & Public Health
Mortality
Pulmonary arteries
Surgery
Surgical Oncology
Thoracic Surgery
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Summary:Congestive heart failure (CHF) is one of the major causes of death and occurs in more than 15,000,000 patients worldwide. The incidence is expected to increase in parallel with the aging population. Most current therapies for CHF are medications, and biventricular pacing implantation as appropriated by cardiologists, or surgical interventions. The heart transplantation for indicated patients is still gold standard surgery although the 10-year survival rate is approximately 60% based on the worldwide data. However, the cardiac transplantation remains epidemiologically insignificant because of donor pool limitations. New strategies for treating CHF are needed. In addition to conventional cardiac surgery, surgical ventricular restoration was reported as a promising surgical therapy in 1990s. After the first report of partial left ventriculectomy in which posterior wall was widely resected for dilated heart, many controversial clinical and animal research studies have been reported. In this review, the principles of posterior cardiac restoration therapy will be discussed. An overview of posterior cardiac restoration, structure, and torsion are presented. By understanding the structure of cardiac muscle, shape, and torsion of left ventricle for surgical restoration, the procedure can be performed based on appropriate indication and this knowledge can be used to optimize and improve its efficacy. The use of mechanical support devices has recently become commonplace in many centers, and the use of implantable ventricular assist devices as destination therapy will increase. Surgeons will be able to select several options of the treatment for CHF by understanding the advantages and disadvantages of those surgical treatments.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-017-0750-8