Left ventricular (LV) reconstruction for ischemic cardiomyopathy has been in the repertoire of cardiac surgeons since the earlier aneurysm repairs more than 40 years ago. The technique has evolved from simple linear repairs of the infarcted free wall of the LV to more complete repairs involving not just the free wall but also the infarcted LV septum. A tremendous variation exists in the extent of infarction, the distribution of scar between the septum and free wall, and the degree of subsequent ventricular dilatation. The effectiveness of linear repair versus more complete repair is related to this variation. The remodeled dilated ventricle increases wall stress in areas remote from the LV aneurysm. The fundamental mechanism behind improved LV function after repair of an aneurysm in the left anterior descending (LAD) distribution is improved function in the circumflex and right coronary artery territories due to reduction in wall stress in these areas remote from the aneurysm.
|Original language||English (US)|
|Title of host publication||Operative Cardiac Surgery, Fifth Edition|
|Number of pages||12|
|State||Published - Jan 1 2004|
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