What is left ventricular reconstruction?
Left ventricular reconstruction surgery, also known as ventricular restoration surgery, treats congestive heart failure and improves your quality of life.
You may need left ventricular reconstruction surgery if you’ve had a heart attack, which can create scar tissue around the heart muscle. This scar tissue doesn’t beat with the rest of the heart and can cause your heart to pump blood inefficiently.
The goal of this surgery is to remove the scar tissue and restore your heart to a more normal shape and size, helping your heart work more efficiently and relieving symptoms of heart failure.
Why is this surgery done?
This surgery fixes damage done to the heart. Congestive heart failure, a common and serious heart disorder, is the result of the heart not being able to keep up the workload of pumping blood to the lungs and the rest of the body.
The heart’s left ventricle works harder than normal to compensate for this deficit, and it becomes enlarged and inefficient.
Symptoms of congestive heart failure include shortness of breath, fluid retention and loss of strength and stamina. When symptoms worsen, you may need hospitalization.
Are you a candidate for left ventricular reconstruction surgery?
You may be a candidate for left ventricular reconstruction if you have an enlarged heart due to a heart attack or an aortic aneurysm and left ventricle scarring.
Additionally, your doctor may recommend this surgery if you have heart failure caused by inefficient heart pumping, or symptoms of congestive heart failure that are not relieved by medication and lifestyle changes.
If your doctors diagnose you with congestive heart failure, they will recommend more tests to determine the best possible treatment.
If your symptoms of congestive heart failure are so severe that you can’t walk short distances or up a flight of stairs without becoming short of breath, or you have problems with fluid retention in your legs or lungs and your cardiologist believes medication isn’t working, surgery may be the best next step.
Your evaluation for surgery may include a cardiac MRI or an echocardiogram. If these advanced imaging studies show large areas of scarring on heart tissue, particularly if the areas have started to “balloon out” (become a ventricular aneurysm), you may be a candidate for ventricular reconstruction surgery. Such surgery is often performed at the same time as coronary artery bypass graft (CABG), mitral valve repair or mitral valve replacement surgery.
Preparing for your left ventricular reconstruction surgery
Prior to your surgery, you’ll meet with your doctor to discuss your medical history, the medications you take and any questions you have.
You may have tests including:
- Echocardiogram (also called echo) – This test uses sound waves to assess the function and structure of the heart muscle and valves.
- Cardiac MRI (cardiac magnetic resonance imaging or CMR) – A noninvasive, sophisticated imaging procedure that uses large magnets and a computer to produce detailed images of the structure and function of the heart while it is beating.
- Cardiac catheterization – A procedure to check for problems in coronary arteries. A long, thin tube (catheter) is inserted into an artery or vein in the groin, arm or neck, then threaded to the heart. The physician injects a contrast solution into the artery and takes X-rays to check for blockage and other abnormalities.
Most patients are admitted to the hospital the day before their procedure.
How is this surgery done?
You’ll receive general anesthesia (medication to make you sleep) during the procedure.
The surgeon makes an incision in your chest and gains access to your heart through your breastbone.
You are connected to a heart-lung machine that will take over the function of your heart and lungs during the procedure. This allows the surgeon to stop your heart to make it easier and safer to work on your heart.
After making an incision in your ventricle, the surgeon locates the damaged tissue and removes it from your heart. The edges of the hole are closed together, or a small tissue patch is used to help close the defect.
After removing you from the heart-lung machine, several small drainage tubes are put in place, your chest incision is closed, your breastbone is brought together with stainless steel wire and you are moved to the intensive care unit.
You will have a breathing tube in place typically only until you are awake to breathe on your own.
Recovery after surgery
You usually remain in the hospital for five to seven days.
Typically, you get out of bed by the day after surgery and are allowed to start eating.
After several days, your drainage tubes are removed. A cardiac rehabilitation team member helps you become more active while you’re still in the hospital to regain your strength and prepare you to go home.
At-home recovery
After about a week, you’ll likely be cleared to go home. Once you go home, it’s important that you have close follow-up care with your heart specialists.
Depending on how you feel, and if there isn’t someone who can help keep an eye on you at home, you may need a short stay in a rehabilitation center near your home.
What are the risks associated with left ventricular reconstruction surgery?
As with any surgery, this surgery carries the risk of complications. Your specific risk depends on your specific health and the extent of damage to your heart. Some risks include:
- Bleeding
- Blood clots
- Heart attack
- Stroke
- Infection
- Irregular heartbeat
Your doctor will review all possible risks and complications with you prior to the surgery.
Why choose Ohio State for ventricular reconstruction surgery?
As a teaching hospital, our team of cardiac surgeons are proud to be a training site for left ventricular reconstruction surgery.
Our physicians were involved in a three-year international study of more than 600 patients with severe chronic heart failure and received left ventricular reconstruction surgery.
The most recent data indicates that 91% of patients were functionally improved or free of the symptoms of congestive heart failure.