Reversing left ventricular remodeling in chronic heart failure: Surgical approaches

Kartikya Ahuja, Gregory A. Crooke, Eugene A. Grossi, Aubrey C. Galloway, Ulrich P. Jorde

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

Chronic heart failure (CHF) has become an epidemic in the United States, with approximately 550,000 new cases annually. With the evolution of pharmacotherapy targeting neurohormonal pathways, the annual mortality in subjects with New York Heart Association (NYHA) class IV CHF has dramatically improved from 52% in the seminal CONSENSUS trial to less than 20% in more recent trials. Suppression of the renin-angiotensin-aldosterone system remains the first line of neurohormonal blockade followed by the addition of selective β-adrenoreceptor blockers. For patients with NYHA class I and II symptoms, mortality rates have decreased to approximately 5% or less per year with the use of angiotensin-converting enzyme inhibitors, β-blockers and aldosterone receptor blockers. However, after achieving optimal doses of the indicated pharmacotherapy, and despite the additional benefits obtained with biventricular pacemakers, there are still many patients who continue to experience signs and symptoms of CHF. Recognizing the beneficial effects of the above treatments on left ventricular (LV) remodeling, strategies have been developed to surgically reshape the left ventricle in patients with LV dilation who have associated poor LV function. This review will discuss the techniques and recent developments regarding surgical reshaping of the dilated, dysfunctional, and remodeled left ventricle.

Original languageEnglish (US)
Pages (from-to)184-190
Number of pages7
JournalCardiology in review
Volume15
Issue number4
DOIs
StatePublished - Jul 1 2007
Externally publishedYes

Keywords

  • Batista procedure
  • Dor procedure
  • Heart failure
  • Remodeling surgery
  • Surgical ventricular reconstruction
  • Volume reduction surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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