Cuatro propuestas para la remodelación ventricular en el tratamiento de la miocardiopatía dilatada

Guasp, Francisco Torrent; Riera, J.; Rodés, Manel Ballester

doi:10.1016/s0300-8932(97)73283-4

Cited by 11 publications

(3 citation statements)

References 2 publications

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“…In the heart, increase of the long axis of the ventricle would give rise to the suction of blood (early rapid filling phase). 12 Due to the spatial configuration of the ascending and descending segments, a rotational movement of the heart occurs. This confirms the echocardiographic observations of the motion of the papillary muscle 3 and recent characterization by nuclear magnetic resonance.…”

Section: Conceptualizing Mechanics Of Ventricular Contraction Based Omentioning

confidence: 99%

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Spatial orientation of the ventricular muscle band: Physiologic contribution and surgical implications

Torrent-Guasp¹,

Ballester²,

Buckberg³

et al. 2001

The Journal of Thoracic and Cardiovascular Surgery

266

189

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I t has been proposed that the ventricular myocardium, both right (RV) and left (LV), exists as a continuous muscle band. 1-4 The band is oriented spatially as a helix formed by basal and apical loops. We hypothesize that this unique anatomy and spatial configuration of the myocardial muscle determine the way the ventricular ejection and filling take place. 5,6 Further, knowledge of this unique morphologic and physiologic characteristic should facilitate development of more effective surgical procedures in congestive heart failure. Unwrapping of the Ventricular Myocardial Band Careful anatomic studies have established the way the cardiac band should be unrolled. 3,4 Unwrapping occurs easily (Figure 1), with least resistance, along a natural cleavage plane. Dissection of the ventricular myocardial band can be accomplished in three steps. In the first step (Figure 2, A), the basal loop is unrolled. The superficial fibers of the anterior aspect of the left ventricle are cut along the anterior interventricular sulcus (see arrow) to pull apart the RV free wall (Figure 2, B). Dissection can then proceed posteriorly following the cleavage plane. In this way the complete basal loop is extended in its full length (Figure 2, C, black and dark gray areas). In the second step (Figure 2, C and D), the aorta is dismounted, which involves separation along the cleavage plane (see arrow in Figure 2, C) defined by the two muscular strata, the fibers of the descending segment (white) and the fibers of the ascending

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Section: Conceptualizing Mechanics Of Ventricular Contraction Based Omentioning

confidence: 99%

“…10 It should also alter our approach to the surgical intervention in heart failure. 12 Reduction ventriculectomy has been recently proposed as a surgical alternative in end-stage heart failure in transplant noncandidates. Although theoretically logical, the technique has not proven surgically efficacious.…”

Section: Surgical Implicationsmentioning

confidence: 99%

Spatial orientation of the ventricular muscle band: Physiologic contribution and surgical implications

Torrent-Guasp¹,

Ballester²,

Buckberg³

et al. 2001

The Journal of Thoracic and Cardiovascular Surgery

266

189

View full text Add to dashboard Cite

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“…The original circular patch used in the reconstruction of the residual tissue gap has been replaced by an oval-shaped patch [ 11 , 12 ], able to assure a better ventricular shape and volume, which have been pointed out as two of the major determinants of steady long-term results [ 13 - 16 ]. Thanks to the improving outcomes of this approach, a new chapter of left ventricular volume reduction has opened [ 17 - 19 ], supported by new and accurate studies on left ventricular geometry and function [ 20 ], with particular interest in myocardial fiber disposition [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

A new surgical ventricular restoration technique to reset residual myocardium's fiber orientation: the "KISS" procedure

Cirillo

2009

Ann Surg Innov Res

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Towards new understanding of the heart structure and function

Torrent-Guasp¹,

Kočica

Corno

et al. 2005

European Journal of Cardio-Thoracic Surgery

224

200

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Structure and function in any organ are inseparable categories, both in health and disease. Whether we are ready to accept, or not, many questions in cardiovascular medicine are still pending, due to our insufficient insight in the basic science. Even so, any new concept encounters difficulties, mainly arising from our inert attitude, which may result either in unjustified acceptance or denial. The ventricular myocardial band concept, developed over the last 50 years, has revealed unavoidable coherence and mutual coupling of form and function in the ventricular myocardium. After more than five centuries long debate on macroscopic structure of the ventricular myocardium, this concept has provided a promising ground for its final understanding. Recent validations of the ventricular myocardial band, reviewed here, as well as future research directions that are pointed out, should initiate much wider scientific interest, which would, in turn, lead to reconciliation of some exceeded concepts about developmental, electrical, mechanical and energetical events in human heart. The benefit of this, of course, would be the most evident in the clinical arena.

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Cuatro propuestas para la remodelación ventricular en el tratamiento de la miocardiopatía dilatada

Cited by 11 publications

References 2 publications

Spatial orientation of the ventricular muscle band: Physiologic contribution and surgical implications

Spatial orientation of the ventricular muscle band: Physiologic contribution and surgical implications

A new surgical ventricular restoration technique to reset residual myocardium's fiber orientation: the "KISS" procedure

Towards new understanding of the heart structure and function

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