Key result
Surgical ventricular reconstruction reduces left ventricle volume and improves survival in post-AMI patients, with normal relative wall thickness identifying candidates at very low risk of surgical mortality.
Why the study?
Does surgical ventricular reconstruction improve outcomes in post-AMI patients with enlarged left ventricles?
Does surgical ventricular reconstruction improve outcomes in post-AMI patients with enlarged left ventricles?
Relative wall thickness is a simple and useful parameter for selecting post-AMI patients with enlarged left ventricles who will benefit from surgical ventricular reconstruction with low mortality risk.
According to previous studies, at least 30% of patients with acute myocardial infarction experience an increase in left ventricular (LV) volume of at least 20% from baseline, despite a successful primary recanalization.1 LV volume is a major determinant of mortality.2 The ultimate goal of surgical ventricular reconstruction (SVR) is to induce a reverse remodeling, excluding the scar from the LV cavity and rebuilding the chamber with volume and shape as physiologically as possible. The goal is to achieve an end-systolic volume index of approximately 60 mL/m2, avoiding sphericalization and respecting the physiologic ellipsoid shape of the left ventricle.
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Lorenzo Menicanti (2021) conducted an editorial in Ischemic cardiomyopathy / Post-acute myocardial infarction (n=165). Surgical ventricular reconstruction (SVR) was evaluated on Surgical mortality and outcome. Surgical ventricular reconstruction reduces left ventricle volume and improves survival in post-AMI patients, with normal relative wall thickness identifying candidates at very low risk of surgical mortality.
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