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Surgical remodeling in ischemic cardiomyopathy

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Opinion statement

Ischemic cardiomyopathy has a very poor prognosis, despite significant advances in pharmacologic therapy in the past decade. Orthotopic heart transplantation is an option for only a small minority of patients. Due to donor shortage and a finite outcome after transplant, nontransplant surgical intervention should be intensively investigated. Coronary artery bypass grafting improves survival in patients with demonstrated myocardial viability. Despite this, patients with the greatest left ventricular volumes do not show an improvement in outcomes. Surgical remodeling results in an improved stress-strain relationship and favorable myocardial remodeling. This may lead to improved survival, improvement in ventricular anatomy, and better quality of life. Surgical remodeling is often combined with revascularization, valve repair, and cardiac resynchronization therapy, along with optimal pharmacologic regimens, to provide a comprehensive therapeutic strategy for patients with this infirmity.

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Authors and Affiliations

  1. Kaufman Center for Heart Failure, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, 44195, Cleveland, OH, USA

    James O. O’Neill MD & Randall C. Starling MD, MPH

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  1. James O. O’Neill MD
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  2. Randall C. Starling MD, MPH
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O’Neill, J.O., Starling, R.C. Surgical remodeling in ischemic cardiomyopathy. Curr Treat Options Cardio Med 5, 311–319 (2003). https://doi.org/10.1007/s11936-003-0030-z

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  • DOI: https://doi.org/10.1007/s11936-003-0030-z

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