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Onohara D, Corporan DM, Kono T, et al. Ventricular reshaping with a beating heart implant improves pump function in experimental heart failure. J Thorac Cardiovasc Surg. 2020;doi: 10.1016/j.jtcvs.2020.08.097.
Onohara, D., Corporan, D. M., Kono, T., Kumar, S., Guyton, R. A., & Padala, M. (2020). Ventricular reshaping with a beating heart implant improves pump function in experimental heart failure. The Journal of thoracic and cardiovascular surgery, . https://doi.org/10.1016/j.jtcvs.2020.08.097
Onohara, Daisuke, et al. "Ventricular reshaping with a beating heart implant improves pump function in experimental heart failure." The Journal of thoracic and cardiovascular surgery vol. (2020). doi: https://doi.org/10.1016/j.jtcvs.2020.08.097
Onohara D, Corporan DM, Kono T, Kumar S, Guyton RA, Padala M. Ventricular reshaping with a beating heart implant improves pump function in experimental heart failure. J Thorac Cardiovasc Surg. 2020 Sep 03; doi: 10.1016/j.jtcvs.2020.08.097. Epub 2020 Sep 03. PMID: 33046233; PMCID: PMC7925703.
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J Thorac Cardiovasc Surg. 2020 Sep 03; doi: 10.1016/j.jtcvs.2020.08.097. Epub 2020 Sep 03.

Ventricular reshaping with a beating heart implant improves pump function in experimental heart failure.

The Journal of thoracic and cardiovascular surgery

Daisuke Onohara, Daniella M Corporan, Takanori Kono, Sandeep Kumar, Robert A Guyton, Muralidhar Padala

Affiliations

  1. Structural Heart Research & Innovation Laboratory, Carlyle Fraser Heart Center, Emory University Hospital Midtown, Atlanta, Ga.
  2. Joint Department of Biomedical Engineering, Emory University/Georgia Institute of Technology, Atlanta, Ga.
  3. Structural Heart Research & Innovation Laboratory, Carlyle Fraser Heart Center, Emory University Hospital Midtown, Atlanta, Ga; Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Ga.
  4. Structural Heart Research & Innovation Laboratory, Carlyle Fraser Heart Center, Emory University Hospital Midtown, Atlanta, Ga; Joint Department of Biomedical Engineering, Emory University/Georgia Institute of Technology, Atlanta, Ga; Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Ga. Electronic address: [email protected].

PMID: 33046233 PMCID: PMC7925703 DOI: 10.1016/j.jtcvs.2020.08.097

Abstract

OBJECTIVE: The left ventricle remodels from an ellipsoidal/conical shape to a spherical shape after a myocardial infarction. The spherical ventricle is inefficient as a pumping chamber, has higher wall stresses, and can lead to congestive heart failure. We sought to investigate if restoring physiological ventricular shape with a beating heart implant improves pump function.

METHODS: Rats were induced with a myocardial infarction, developing left ventricular dilatation and dysfunction, and becoming spherical over 3 weeks. Thereafter, they were randomized to undergo left ventricular reshaping with a beating heart implant (n = 19) or continue follow-up without an implant (n = 19). Biweekly echocardiography was performed until 12 weeks, with half the rats euthanized at 6 weeks and remaining at 12 weeks. At termination, invasive hemodynamic parameters and histopathology were performed.

RESULTS: At 3 weeks after the infarction, rats had a 22% fall in ejection fraction, 31% rise in end diastolic volume, and 23% rise in sphericity. Transventricular implant reshaping reduced the volume by 12.6% and sphericity by 21%, restoring physiologic ventricular shape and wall stress. Over the 12-week follow-up, pump function improved significantly with better ventricular-vascular coupling in the reshaped hearts. In this group, cardiomyocyte cross-section area was higher and the cells were less elongated.

CONCLUSIONS: Reshaping a postinfarction, failing left ventricle to restore its physiological conical shape significantly improves long-term pump function.

Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Keywords: adverse remodeling; helical fibers; ischemic cardiomyopathy; sphericity; ventricular shape

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