Left Ventricular Reconstruction:from Anatomy to Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FANHong-guang , ZHENGZhe ,  HUSheng-shou

Depar-tment of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fu wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P. R. China;

Corresponding author：

HUSheng-shou, Email: shengshouhu@yahoo.com

Keywords：

Left ventricular reconstruction; Helical myocardial band; Coronary artery disease

DOI：

10.7507/1007-4848.20140153

Video：

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Beginning from the epidemiology of coronary heart disease, the authors firstly analyze the pathology and pathophysiology of the infarcted heart. Back to the basic anatomy of heart muscles, the authors then review the development history of basic anatomy theory of heart muscle fibers, focusing mainly on the helical myocardial band theory. This part covers theories of evolutionary biology, developmental biology, and modern imaging evidence on cardiac structures, as well as the intrinsic link between structures and functions of the heart. The relation between cardiac geometry and function is analyzed with helical myocardial band theory. Then returning to clinical problems, the authors introduce the development of left ventricular reconstruction (LVR), the impact of helical myocardial band theory on LVR, current status and disputes of LVR, and future prospect of LVR.

Citation： FANHong-guang, ZHENGZhe, HUSheng-shou. Left Ventricular Reconstruction:from Anatomy to Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(4): 542-547. doi: 10.7507/1007-4848.20140153 Copy

1.	Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics--2007 update:a report from the American Heart Associ-ation Statistics Committee and Stroke Statistics Subcommittee.Circulation, 2007, 115 (5):e69-171.
2.	孔灵芝, 胡盛寿, 主编.中国心血管病报告. 2006.北京:中国大百科全书出版社, 2008. 36-38.
3.	Buckberg GD. Ventricular structures must be understood during surgical restoration for heart failure. Scand J Surg, 2007, 96 (2):164-176.
4.	Kocica MJ. The helical ventricular myocardial band:global, three-dimensional, functional architecture of the ventricular myocardium. Eur J Cardiothorac Surg, 2006, 29 (Suppl 1):s21-s40.
5.	Torrent-Guasp F, Ballester M, Buckberg GD, et al. Spatial orientation of the ventricular muscle band:physiologic contribution and surgical implications. J Thorac Cardiovasc Surg, 2001, 122 (2):389-392.
6.	Buckberg GD, Coghlan HC, Hoffman JI, et al. The structure and function of the helical heart and its buttress wrapping. Ⅶ. Critical importance of septum for right ventricular function. Semin Thorac Cardiovasc Surg, 2001, 13 (4):402-416.
7.	Buckberg GD. Basic science review:the helix and the heart. J Thorac Cardiovasc Surg, 2002, 124 (5):863-883.
8.	Helm P, Beg MF, Miller MI, et al. Measuring and mapping cardiac fiber and laminar architecture using diffusion tensor MR imaging. Ann N Y Acad Sci, 2005, 1047 (6):296-307.
9.	Buckberg G, Hoffman JI, Mahajan A, et al. Cardiac mechanics revisited:the relationship of cardiac architecture to ventricular function. Circulation, 2008, 118 (24):2571-2587.
10.	Buckberg G. Ventricular structure and surgical history. Heart Fail Rev, 2004, 9 (4):255-268, 347-351.
11.	Buckberg GD. Form versus disease:optimizing geometry during ventricular restoration. Eur J Cardiothorac Surg, 2006, 29 (Suppl 1):S238-S244.
12.	Buckberg GD, Athanasuleas CL, RESTORE Group. Seeing congestive heart failure with the eyes of the mind:a surgical view. Semin Thorac Cardiovasc Surg, 2001, 13 (4):431-434.
13.	Buckberg GD. Ventricular restoration-a surgical approach to reverse ventricular remodeling. Heart Fail Rev, 2004, 9 (4):233-239, 347-351.
14.	White HD, Norris RM, Brown MA, et al. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation, 1987, 76 (1):44-51.
15.	Likoff W, Bailey CP. Ventriculoplasty:excision of myocardial aneurysm; report of a successful case. J Am Med Assoc, 1955, 158 (11):915-920.
16.	Cooley DA, Collins HA, Morris GC, et al. Ventricular aneurysm after myocardial infarction; surgical excision with use of temporary cardiopulmonary bypass. J Am Med Assoc, 1958, 167 (5):557-560.
17.	Hutchins GM, Bulkley BH, Moore GW, et al., Shape of the human cardiac ventricles. Am J Cardiol, 1978, 41 (4):646-654.
18.	Jatene AD. Left ventricular aneurysmectomy. Resection or reconstruction. J Thorac Cardiovasc Surg, 1985, 89 (3):321-331.
19.	Dor V, Saab M, Coste P, et al. Left ventricular aneurysm:a new surgical approach. Thorac Cardiovasc Surg, 1989, 37 (1):11-19.
20.	Cooley DA. Ventricular endoaneurysmorrhaphy:a simplified repair for extensive postinfarction aneurysm. J Card Surg, 1989, 4 (3):200-205.
21.	Enomoto Y, Gorman JH, Moainie SL, et al. Early ventricular restr-aint after myocardial infarction:extent of the wrap determines the outcome of remodeling. Ann Thorac Surg, 2005, 79 (3):881-887.
22.	Fan HG, Zheng Z, Feng W, et al. Repair of left ventricular aneurysm:ten-year experience in Chinese patients. Chin Med J (Engl), 2009, 122 (17):1963-1968.
23.	吴洪斌, 胡盛寿, 周玉燕.左心室巨大室壁瘤手术治疗的中远期随访研究.中华外科杂志, 2001, 39 (12):928-930.
24.	Zheng Z, Fan HG, Feng W, et al. Surgery of left ventricular aneurysm:a propensity score-matched study of outcomes following different repair techniques. Interact Cardiovasc Thorac Surg, 2009, 9 (3):431-436.
25.	Schenk S, Mccarthy PM, Starling RC, et al. Neurohormonal response to left ventricular Reconstruction surgery in ischemic cardiomyopathy. J Thorac Cardiovasc Surg, 2004, 128 (1):38-43.
26.	Caldeira C, Mccarthy PM. A simple method of left ventricular Recon-struction without patch for ischemic cardiomyopathy. Ann Thorac Surg, 2001, 72 (6):2148-2149.
27.	O'neill JO, Starling RC, Mccarthy PM, et al. The impact of left ventricular Reconstruction on survival in patients with ischemic cardio-myopathy. Eur J Cardiothorac Surg, 2006, 30 (5):753-759.
28.	Isomura T, Horii T, Suma H, et al. Septal anterior ventricular exclu-sion operation (Pacopexy) for ischemic dilated cardiomyopathy:treat form not disease. Eur J Cardiothorac Surg, 2006, 29 (Suppl 1):S245-S250.
29.	Walker JC, Ratcliffe MB, Zhang P, et al. MRI-based finite-element analysis of left ventricular aneurysm. Am J Physiol Heart Circ Physiol, 2005, 289 (2):H692-H700.
30.	Hsu CP, Huang CY, Wang JS, et al. Down-regulation of apoptosis after left ventricular aneurysm repair. Ann Thorac Surg, 2007, 84 (4):1279-1287.
31.	Hsu CP, Huang CY, Wang JS, et al. Extracellular matrix remodeling attenuated after experimental postinfarct left ventricular aneurysm repair. Ann Thorac Surg, 2008, 86 (4):1243-1249.
32.	Athanasuleas CL, Buckberg GD, Stanley AW, et al. Surgical ventri-cular restoration:the RESTORE Group experience. Heart Fail Rev, 2004, 9 (4):287-297.
33.	Buckberg GD, Athanasuleas CL. The STICH trial:misguided concl-usions. J Thorac Cardiovasc Surg, 2009, 138 (5):1060-1064.e2.
34.	Athanasuleas CL, Stanley AW, Buckberg GD, et al. Surgical anterior ventricular endocardial restoration (SAVER) for dilated ischemic cardiomyopathy. Semin Thorac Cardiovasc Surg, 2001, 13 (4):448-458.
35.	Jones RH, Velazquez EJ, Michler RE, et al. Coronary Bypass Surgery with or without Surgical Ventricular Reconstruction. N Engl J Med, 2009, 360 (17):1705-1717.
36.	Liu J, Liu ZX, Zhao Q, et al. Role of surgical ventricular restoration in the treatment of ischemic cardiomyopathy. Ann Thorac Surg, 2013, 95 (4):1315-1321.
37.	Goh S, Prior D, Newcomb A, et al. Surgical ventricular restoration procedure:single-center comparison of Surgical Treatment of Ischemic Heart Failure (STICH) versus non-STICH patients. Ann Thorac Surg, 2013, 95 (2):506-512.
38.	Witkowski TG, ten Brinke EA, Delgado V, et al. Surgical ventricular restoration for patients with ischemic heart failure:determinants of two-year survival. Ann Thorac Surg, 2011, 91 (2):491-498.
39.	Parolari A, Naliato M, Loardi C, et al. Surgery of left ventricular aneurysm:a meta-analysis of early outcomes following different Reconstruction techniques. Ann Thorac Surg, 2007, 83 (6):2009-2016.
40.	Adhyapak SM, Menon PG, Rao Parachuri V. Restoration of optimal ellipsoid left ventricular geometry:lessons learnt from in silico surgical modelling. Interact Cardiovasc Thorac Surg, 2014, 18 (2):153-158.
41.	Dor V. Left ventricular Reconstruction:the aim and the reality after twenty years. J Thorac Cardiovasc Surg, 2004, 128 (1):17-20.
42.	Dang AB, Guccione JM, Zhang P, et al. Effect of ventricular size and patch stiffness in surgical anterior ventricular restoration:a finite element model study. Ann Thorac Surg, 2005, 79 (1):185-193.
43.	Otasevic P, Sagic D, Antonic Z, et al. First-in-man implantation of left ventricular partitioning device in a patient with chronic heart failure:twelve-month follow-up. J Card Fail, 2007, 13 (7):517-520.
44.	Mazzaferri EL, Gradinac S, Sagic D, et al. Percutaneous left ventri-cular partitioning in patients with chronic heart failure and a prior anterior myocardial infarction:Results of the PercutAneous Ventricular RestorAtion in Chronic Heart failUre PaTiEnts Trial. Am Heart J, 2012, 163 (5):812-820.e1.
45.	Costa MA, Pencina M, Nikolic S, et al. The PARACHUTE IV trial design and rationale:percutaneous ventricular restoration using the parachute device in patients with ischemic heart failure and dilated left ventricles. Am Heart J, 2013, 165 (4):531-536.
46.	Tang YL, Wang YJ, Chen LJ, et al. Cardiac-derived stem cell-based therapy for heart failure:progress and clinical applications. Exp Biol Med (Maywood), 2013, 238 (3):294-300.
47.	Bockeria L, Bogin V, Bockeria O, et al. Endometrial regenerative cells for treatment of heart failure:a new stem cell enters the clinic. J Transl Med, 2013, 11 (5):56.
48.	Bergmann O, Bhardwaj RD, Bernard S, et al. Evidence for cardiomyocyte renewal in humans. Science, 2009, 324 (5923):98-102.
49.	Babokin V, Shipulin V, Batalov R, et al. Surgical ventricular Recons-truction with endocardectomy along radiofrequency ablation-induced markings. J Thorac Cardiovasc Surg, 2013, 146 (5):1133-1138.
50.	Suma H, RESTORE Group. Left ventriculoplasty for nonischemic dilated cardiomyopathy. Semin Thorac Cardiovasc Surg, 2001, 13 (4):514-521.
51.	Suma H, Horii T, Isomura T, et al. A new concept of ventricular restoration for nonischemic dilated cardiomyopathy. Eur J Cardiothorac Surg, 2006, 29 (Suppl 1):S207-S212.

1. Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics--2007 update:a report from the American Heart Associ-ation Statistics Committee and Stroke Statistics Subcommittee.Circulation, 2007, 115 (5):e69-171.
2. 孔灵芝, 胡盛寿, 主编.中国心血管病报告. 2006.北京:中国大百科全书出版社, 2008. 36-38.
3. Buckberg GD. Ventricular structures must be understood during surgical restoration for heart failure. Scand J Surg, 2007, 96 (2):164-176.
4. Kocica MJ. The helical ventricular myocardial band:global, three-dimensional, functional architecture of the ventricular myocardium. Eur J Cardiothorac Surg, 2006, 29 (Suppl 1):s21-s40.
5. Torrent-Guasp F, Ballester M, Buckberg GD, et al. Spatial orientation of the ventricular muscle band:physiologic contribution and surgical implications. J Thorac Cardiovasc Surg, 2001, 122 (2):389-392.
6. Buckberg GD, Coghlan HC, Hoffman JI, et al. The structure and function of the helical heart and its buttress wrapping. Ⅶ. Critical importance of septum for right ventricular function. Semin Thorac Cardiovasc Surg, 2001, 13 (4):402-416.
7. Buckberg GD. Basic science review:the helix and the heart. J Thorac Cardiovasc Surg, 2002, 124 (5):863-883.
8. Helm P, Beg MF, Miller MI, et al. Measuring and mapping cardiac fiber and laminar architecture using diffusion tensor MR imaging. Ann N Y Acad Sci, 2005, 1047 (6):296-307.
9. Buckberg G, Hoffman JI, Mahajan A, et al. Cardiac mechanics revisited:the relationship of cardiac architecture to ventricular function. Circulation, 2008, 118 (24):2571-2587.
10. Buckberg G. Ventricular structure and surgical history. Heart Fail Rev, 2004, 9 (4):255-268, 347-351.
11. Buckberg GD. Form versus disease:optimizing geometry during ventricular restoration. Eur J Cardiothorac Surg, 2006, 29 (Suppl 1):S238-S244.
12. Buckberg GD, Athanasuleas CL, RESTORE Group. Seeing congestive heart failure with the eyes of the mind:a surgical view. Semin Thorac Cardiovasc Surg, 2001, 13 (4):431-434.
13. Buckberg GD. Ventricular restoration-a surgical approach to reverse ventricular remodeling. Heart Fail Rev, 2004, 9 (4):233-239, 347-351.
14. White HD, Norris RM, Brown MA, et al. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation, 1987, 76 (1):44-51.
15. Likoff W, Bailey CP. Ventriculoplasty:excision of myocardial aneurysm; report of a successful case. J Am Med Assoc, 1955, 158 (11):915-920.
16. Cooley DA, Collins HA, Morris GC, et al. Ventricular aneurysm after myocardial infarction; surgical excision with use of temporary cardiopulmonary bypass. J Am Med Assoc, 1958, 167 (5):557-560.
17. Hutchins GM, Bulkley BH, Moore GW, et al., Shape of the human cardiac ventricles. Am J Cardiol, 1978, 41 (4):646-654.
18. Jatene AD. Left ventricular aneurysmectomy. Resection or reconstruction. J Thorac Cardiovasc Surg, 1985, 89 (3):321-331.
19. Dor V, Saab M, Coste P, et al. Left ventricular aneurysm:a new surgical approach. Thorac Cardiovasc Surg, 1989, 37 (1):11-19.
20. Cooley DA. Ventricular endoaneurysmorrhaphy:a simplified repair for extensive postinfarction aneurysm. J Card Surg, 1989, 4 (3):200-205.
21. Enomoto Y, Gorman JH, Moainie SL, et al. Early ventricular restr-aint after myocardial infarction:extent of the wrap determines the outcome of remodeling. Ann Thorac Surg, 2005, 79 (3):881-887.
22. Fan HG, Zheng Z, Feng W, et al. Repair of left ventricular aneurysm:ten-year experience in Chinese patients. Chin Med J (Engl), 2009, 122 (17):1963-1968.
23. 吴洪斌, 胡盛寿, 周玉燕.左心室巨大室壁瘤手术治疗的中远期随访研究.中华外科杂志, 2001, 39 (12):928-930.
24. Zheng Z, Fan HG, Feng W, et al. Surgery of left ventricular aneurysm:a propensity score-matched study of outcomes following different repair techniques. Interact Cardiovasc Thorac Surg, 2009, 9 (3):431-436.
25. Schenk S, Mccarthy PM, Starling RC, et al. Neurohormonal response to left ventricular Reconstruction surgery in ischemic cardiomyopathy. J Thorac Cardiovasc Surg, 2004, 128 (1):38-43.
26. Caldeira C, Mccarthy PM. A simple method of left ventricular Recon-struction without patch for ischemic cardiomyopathy. Ann Thorac Surg, 2001, 72 (6):2148-2149.
27. O'neill JO, Starling RC, Mccarthy PM, et al. The impact of left ventricular Reconstruction on survival in patients with ischemic cardio-myopathy. Eur J Cardiothorac Surg, 2006, 30 (5):753-759.
28. Isomura T, Horii T, Suma H, et al. Septal anterior ventricular exclu-sion operation (Pacopexy) for ischemic dilated cardiomyopathy:treat form not disease. Eur J Cardiothorac Surg, 2006, 29 (Suppl 1):S245-S250.
29. Walker JC, Ratcliffe MB, Zhang P, et al. MRI-based finite-element analysis of left ventricular aneurysm. Am J Physiol Heart Circ Physiol, 2005, 289 (2):H692-H700.
30. Hsu CP, Huang CY, Wang JS, et al. Down-regulation of apoptosis after left ventricular aneurysm repair. Ann Thorac Surg, 2007, 84 (4):1279-1287.
31. Hsu CP, Huang CY, Wang JS, et al. Extracellular matrix remodeling attenuated after experimental postinfarct left ventricular aneurysm repair. Ann Thorac Surg, 2008, 86 (4):1243-1249.
32. Athanasuleas CL, Buckberg GD, Stanley AW, et al. Surgical ventri-cular restoration:the RESTORE Group experience. Heart Fail Rev, 2004, 9 (4):287-297.
33. Buckberg GD, Athanasuleas CL. The STICH trial:misguided concl-usions. J Thorac Cardiovasc Surg, 2009, 138 (5):1060-1064.e2.
34. Athanasuleas CL, Stanley AW, Buckberg GD, et al. Surgical anterior ventricular endocardial restoration (SAVER) for dilated ischemic cardiomyopathy. Semin Thorac Cardiovasc Surg, 2001, 13 (4):448-458.
35. Jones RH, Velazquez EJ, Michler RE, et al. Coronary Bypass Surgery with or without Surgical Ventricular Reconstruction. N Engl J Med, 2009, 360 (17):1705-1717.
36. Liu J, Liu ZX, Zhao Q, et al. Role of surgical ventricular restoration in the treatment of ischemic cardiomyopathy. Ann Thorac Surg, 2013, 95 (4):1315-1321.
37. Goh S, Prior D, Newcomb A, et al. Surgical ventricular restoration procedure:single-center comparison of Surgical Treatment of Ischemic Heart Failure (STICH) versus non-STICH patients. Ann Thorac Surg, 2013, 95 (2):506-512.
38. Witkowski TG, ten Brinke EA, Delgado V, et al. Surgical ventricular restoration for patients with ischemic heart failure:determinants of two-year survival. Ann Thorac Surg, 2011, 91 (2):491-498.
39. Parolari A, Naliato M, Loardi C, et al. Surgery of left ventricular aneurysm:a meta-analysis of early outcomes following different Reconstruction techniques. Ann Thorac Surg, 2007, 83 (6):2009-2016.
40. Adhyapak SM, Menon PG, Rao Parachuri V. Restoration of optimal ellipsoid left ventricular geometry:lessons learnt from in silico surgical modelling. Interact Cardiovasc Thorac Surg, 2014, 18 (2):153-158.
41. Dor V. Left ventricular Reconstruction:the aim and the reality after twenty years. J Thorac Cardiovasc Surg, 2004, 128 (1):17-20.
42. Dang AB, Guccione JM, Zhang P, et al. Effect of ventricular size and patch stiffness in surgical anterior ventricular restoration:a finite element model study. Ann Thorac Surg, 2005, 79 (1):185-193.
43. Otasevic P, Sagic D, Antonic Z, et al. First-in-man implantation of left ventricular partitioning device in a patient with chronic heart failure:twelve-month follow-up. J Card Fail, 2007, 13 (7):517-520.
44. Mazzaferri EL, Gradinac S, Sagic D, et al. Percutaneous left ventri-cular partitioning in patients with chronic heart failure and a prior anterior myocardial infarction:Results of the PercutAneous Ventricular RestorAtion in Chronic Heart failUre PaTiEnts Trial. Am Heart J, 2012, 163 (5):812-820.e1.
45. Costa MA, Pencina M, Nikolic S, et al. The PARACHUTE IV trial design and rationale:percutaneous ventricular restoration using the parachute device in patients with ischemic heart failure and dilated left ventricles. Am Heart J, 2013, 165 (4):531-536.
46. Tang YL, Wang YJ, Chen LJ, et al. Cardiac-derived stem cell-based therapy for heart failure:progress and clinical applications. Exp Biol Med (Maywood), 2013, 238 (3):294-300.
47. Bockeria L, Bogin V, Bockeria O, et al. Endometrial regenerative cells for treatment of heart failure:a new stem cell enters the clinic. J Transl Med, 2013, 11 (5):56.
48. Bergmann O, Bhardwaj RD, Bernard S, et al. Evidence for cardiomyocyte renewal in humans. Science, 2009, 324 (5923):98-102.
49. Babokin V, Shipulin V, Batalov R, et al. Surgical ventricular Recons-truction with endocardectomy along radiofrequency ablation-induced markings. J Thorac Cardiovasc Surg, 2013, 146 (5):1133-1138.
50. Suma H, RESTORE Group. Left ventriculoplasty for nonischemic dilated cardiomyopathy. Semin Thorac Cardiovasc Surg, 2001, 13 (4):514-521.
51. Suma H, Horii T, Isomura T, et al. A new concept of ventricular restoration for nonischemic dilated cardiomyopathy. Eur J Cardiothorac Surg, 2006, 29 (Suppl 1):S207-S212.

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