ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Peng Zhang
Robert C. Gorman
Joseph H. Gorman, III
Mark B. Ratcliffe
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dang, A. B.C.
Right arrow Articles by Ratcliffe, M. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dang, A. B.C.
Right arrow Articles by Ratcliffe, M. B.
Related Collections
Right arrow Congestive Heart Failure

Ann Thorac Surg 2005;79:185-193
© 2005 The Society of Thoracic Surgeons


Original article: Cardiovascular

Effect of Ventricular Size and Patch Stiffness in Surgical Anterior Ventricular Restoration: A Finite Element Model Study

Alan B.C. Dang, BSa, Julius M. Guccione, PhDb,c,*, Peng Zhang, MD, PhDb, Arthur W. Wallace, MD, PhDd, Robert C. Gorman, MDe, Joseph H. Gorman, III, MDe, Mark B. Ratcliffe, MDb,c

a School of Medicine of the University of California, San Francisco, San Francisco, California, USA
b Department of Surgery, University of California, San Francisco, San Francisco, California, USA
c Department of Bioengineering, University of California, San Francisco, San Francisco, California, USA
d Department of Anesthesia, University of California, San Francisco, San Francisco, California, USA, and San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
e Department of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA

Accepted for publication June 4, 2004.

* Address reprint requests to Dr Guccione, Division of Surgical Services (112D), San Francisco Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA94121 (E-mail: Julius.Guccione{at}med.va.gov).

BACKGROUND: Surgical anterior ventricular restoration (SAVER) has been proposed for dilated ischemic cardiomyopathy with an akinetic distal anterior left ventricular wall. We tested the hypothesis that SAVER increases stroke volume, reduces mean myofiber stress and achieves optimal results without a patch.

METHODS: A finite element model of the left ventricle (LV) with an akinetic but contractile anteroapical LV wall segment was used. Separate versions of the model with normal and dilated LV sizes were developed and used to simulate the SAVER operation with and without a patch of varying stiffness from 10 to 100 kilopascals.

RESULTS: The SAVER operation reduced myofiber stress in the akinetic infarct and infarct borderzone, but caused a reduction in the Starling relationship. In all cases, stroke volume decreased while ejection fraction increased after SAVER. The SAVER operation was more beneficial in dilated ventricles, and the reduction in stroke volume after SAVER without patch was minimal. The effect of patch stiffness was mixed as stiffer material causes a greater reduction in stress yet has the greatest negative effect on stroke volume.

CONCLUSIONS: These simulations support the use of SAVER in dilated hearts without a patch.




This article has been cited by other articles:


Home page
J Am Coll CardiolHome page
P. Ferrazzi, M. Senni, M. R. Iascone, M. Merlo, M. Triggiani, R. Lorusso, P. Herijgers, J. J. Schreuder, S. Pentiricci, A. Iacovoni, et al.
Implantation of an Elastic Ring at Equator of the Left Ventricle Influences Cardiac Mechanics in Experimental Acute Ventricular Dysfunction
J. Am. Coll. Cardiol., October 30, 2007; 50(18): 1791 - 1798.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
P. Zhang, J. M. Guccione, S. I. Nicholas, J. C. Walker, P. C. Crawford, A. Shamal, G. Acevedo-Bolton, M. A. Guttman, C. Ozturk, E. R. McVeigh, et al.
Endoventricular patch plasty for dyskinetic anteroapical left ventricular aneurysm increases systolic circumferential shortening in sheep.
J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 1017 - 1024.e1.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
M. B. Ratcliffe and T. S. Guy
The effect of preoperative diastolic dysfunction on outcome after surgical ventricular remodeling
J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 280 - 283.
[Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
S. A.F. Tulner, P. Steendijk, R. J.M. Klautz, J. J. Bax, M. J. Schalij, E. E. van der Wall, and R. A.E. Dion
Surgical ventricular restoration in patients with ischemic dilated cardiomyopathy: Evaluation of systolic and diastolic ventricular function, wall stress, dyssynchrony, and mechanical efficiency by pressure-volume loops.
J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 610 - 620.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
P. Zhang, J. M. Guccione, S. I. Nicholas, J. C. Walker, P. C. Crawford, A. Shamal, D. A. Saloner, A. W. Wallace, and M. B. Ratcliffe
Left ventricular volume and function after endoventricular patch plasty for dyskinetic anteroapical left ventricular aneurysm in sheep
J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1032 - 1038.
[Abstract] [Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2005 by The Society of Thoracic Surgeons.