Surgical ventricular restoration - New horizons in the treatment of ischemic cardiomyopathy

Heart failure is a major health problem with increasing prevalence due to aging of the population and in addition to an increase in effective treatment and early myocardial reperfusion during acute myocardial infarction. Postinfarction left ventricular remodeling is characterized by chamber dilatation with an abnormal spherical shape leading to systolic and diastolic dysfunction frequently associated with mitral valve insufficiency and eventually heart failure. Intensive medical management reduces symptoms and improves survival. However, patients who are in NYHA functional class III or IV still have a poor prognosis. In this review article we will endeavor to summarize the emerging surgical approach surgical ventricular restoration for treating ventricular remodeling and ischemic cardiomyopathy. These concepts of restoration of the elliptical shape of the left ventricle and re-establishing the normal structure of the subvalvular mitral apparatus are performed recently in our department.