Renewal of left ventricular torsion after modified surgical anterior ventricular restoration

J Cardiovasc Med (Hagerstown). 2008 Nov;9(11):1142-6. doi: 10.2459/JCM.0b013e328309ea84.

Abstract

Aims: We present a case of surgical anterior ventricular restoration for ischemic cardiomyopathy performed by a modified surgical technique, in which we obtained the renewal of left ventricular torsion.

Methods: We set a modified restoration technique utilizing a strip patch with the aim to realign fibers displaced by postinfarction fibrosis. We studied left ventricular basal and apical rotation and global torsion preoperatively and postoperatively by means of two-dimensional speckle-tracking echocardiography.

Results: Although torsion was completely upset before the operation, due to the remodeled ventricular geometry and to the loss of apex contraction, we demonstrated the renewal of twist motion at the early postoperative assessment, with the regaining of physiologic characteristics and morphology.

Conclusions: As torsion is a specific movement of a healthy heart, due to fiber disposition and orientation through the ventricular wall, its early renewal could be considered an indirect but valuable proof of fiber realignment with the described novel technique.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiac Surgical Procedures*
  • Cardiomyopathies / diagnostic imaging
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / surgery*
  • Echocardiography, Doppler, Color
  • Female
  • Fibrosis
  • Humans
  • Myocardial Contraction*
  • Myocardial Ischemia / diagnostic imaging
  • Myocardial Ischemia / physiopathology
  • Myocardial Ischemia / surgery*
  • Myocardium / pathology
  • Rotation
  • Torsion Abnormality / diagnostic imaging
  • Torsion Abnormality / physiopathology
  • Torsion Abnormality / surgery*
  • Torsion, Mechanical
  • Treatment Outcome
  • Ventricular Function, Left*
  • Ventricular Remodeling*