Abstract
Surgical ventricular restoration (Dor procedure) is generally thought to reduce left ventricular (LV) myofiber stress (FS) but to adversely affect pump function. However, the underlying mechanism is unclear. The goal of this study was to determine the effect of residual stress (RS) on LV FS and pump function after the Dor procedure. Previously described finite element models of the LV based on magnetic resonance imaging data obtained in 5 sheep 16 weeks after anteroapical myocardial infarction were used. Simulated polyethylene terephthalate fiber (Dacron) patches that were elliptical and 25% of the infarct opening area were implanted using a virtual suture technique (VIRTUAL-DOR). In each case, diastole and systole were simulated, and RS, FS, LV volumes, systolic and diastolic function, and pump (Starling) function were calculated. VIRTUAL-DOR was associated with significant RS that was tensile (2.89 ± 1.31 kPa) in the remote myocardium and compressive (234.15 ± 65.53 kPa) in the border zone. VIRTUAL-DOR+RS (compared with VIRTUAL-DOR-NO-RS) was associated with further reduction in regional diastolic and systolic FS, with the greatest change in the border zone (43.5-fold and 7.1-fold, respectively; p < 0.0001). VIRTUAL-DOR+RS wa...Continue Reading
References
Feb 1, 1991·Journal of Biomechanical Engineering·J M GuccioneL K Waldman
Feb 1, 1989·The Thoracic and Cardiovascular Surgeon·V DorF Montiglio
Feb 1, 1993·Journal of Biomechanical Engineering·J M GuccioneA D McCulloch
Dec 2, 1998·The Journal of Thoracic and Cardiovascular Surgery·J Y Kresh, A S Wechsler
Mar 10, 2001·The Annals of Thoracic Surgery·J M GuccioneM K Pasque
Sep 8, 2001·The Journal of Thoracic and Cardiovascular Surgery·J M GuccioneM B Ratcliffe
Dec 29, 2004·The Annals of Thoracic Surgery·Alan B C DangMark B Ratcliffe
Nov 30, 2005·Journal of Biomechanics·M Van LoockeC K Simms
Aug 29, 2006·The Journal of Thoracic and Cardiovascular Surgery·Daniel Burkhoff, Andrew S Wechsler
Aug 29, 2006·The Journal of Thoracic and Cardiovascular Surgery·Sven A F TulnerRobert A E Dion
Jul 31, 2007·The Journal of Thoracic and Cardiovascular Surgery·Lorenzo MenicantiMarisa Di Donato
Oct 2, 2007·The Journal of Thoracic and Cardiovascular Surgery·Peng ZhangMark B Ratcliffe
May 6, 2008·The Journal of Thoracic and Cardiovascular Surgery·Joseph C WalkerJulius M Guccione
Mar 31, 2009·The New England Journal of Medicine·Robert H JonesUNKNOWN STICH Hypothesis 2 Investigators
Aug 7, 2009·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Gerhard A Holzapfel, Ray W Ogden
Dec 18, 2009·Journal of Biomechanical Engineering·Kay SunJulius M Guccione
Jan 28, 2010·The Annals of Thoracic Surgery·Choon-Sik JhunJulius M Guccione
Mar 20, 2010·The Journal of Thoracic and Cardiovascular Surgery·Kay SunMark B Ratcliffe
Jan 17, 2012·The Annals of Thoracic Surgery·Vincent M WongLiang Ge
May 9, 2012·The Annals of Thoracic Surgery·Richard CarrickMark B Ratcliffe