What is a ventricular resection?
Ventricular resection is a surgery to treat heart failure when a patient has been diagnosed with an enlarged heart. It usually involves reshaping or reducing an over-sized left ventricle, the main pumping chamber of the heart. There are different types of ventricular resection surgery. Procedures include:
- Surgical Ventricular Restoration (SVR)
- Ventricular aneurysmectomy
- Left Ventricular (LV) Reconstruction
- The Dor Procedure.
Sometimes, ventricular resection is combined with coronary artery bypass surgery or valve repair.
Why is it done?
The goal of ventricular resection is to restore the heart to a more normal size and shape in order to improve its ability to pump blood. Enhanced blood circulation relieves the symptoms of heart failure (shortness of breath, swelling, fatigue, and angina). Ventricular resection may be performed on people who have developed heart failure or heart enlargement because of:
- A previous heart attack.
- Dilated cardiomyopathy.
- Hypertensive cardiomyopathy.
Ventricular resection is not a cure for heart failure. It remains important to maintain a healthy lifestyle after the surgery as advised by your healthcare provider.
What is done?
- The heart is stopped and the patient is placed on a heart-lung machine.
- The heart is opened.
- If there is scar tissue or an aneurysm, the affected tissue will be cut out.
- The surgeon will try to reshape the left ventricle so it is smaller and restores the elliptical shape of the heart.
These changes will significantly improve the pumping action of the heart.
What can you expect?
Before the surgery
Usually, the surgery is scheduled ahead of time. A week or so before your operation, you will probably be asked to visit your hospital. Various tests, such as blood and urine tests, an electrocardiogram, an echocardiogram, an X-ray and other tests may be performed. Your doctor will explain the risks and benefits of the procedure and you will be asked to sign a consent form. Before the procedure starts, inform your doctor if you:
- Have ever had a reaction to any contrast dye, iodine, or any serious allergic reaction (for example, from a bee sting or from eating shellfish).
- Have asthma.
- Are allergic to any medication.
- Have any bleeding problems or are taking blood-thinning medication.
- Have a history of kidney problems or diabetes.
- Have body piercings on your chest or abdomen.
- Have had any recent change in your health.
- Are, or may be, pregnant.
Most patients are admitted to the hospital the day before their procedure.
The night before, you will be asked to bathe to reduce the amount of germs on your skin. At the hospital, the area to be operated on will be washed, scrubbed with an antiseptic and, if needed, shaved.
During the operation
Ventricular resection is a form of open-heart surgery and is conducted under a general anesthetic, so you will be asleep throughout the procedure. To reduce the risk of vomiting while asleep, you will be asked not to eat or drink after midnight the night before surgery. If you smoke, you should stop at least two weeks before your surgery, as smoking can contribute to blood clotting and breathing problems.
After you are completely asleep, three tubes will be inserted:
- a tube down your windpipe, which will be connected to a machine called a respirator to take over your breathing during the surgery.
- a tube into your stomach to stop liquid and air from collecting in your stomach so you will not feel sick and bloated when you wake up.
- a tube into your bladder to collect any urine produced during the operation.
To ensure your body continues to receive a flow of oxygen-rich blood, you will be hooked up to a heart-lung machine. This machine takes over the pumping action of the heart.
The length of time the surgery requires will depend upon what is being done. Often, ventricular resection is combined with coronary artery bypass surgery or with the repair of one or more heart valves.
After the operation
When you awaken, you will be in the recovery room or an intensive care unit (ICU). You can expect to stay in the hospital at least three to five days. How quickly you recover from surgery will depend on how healthy you were before the surgery.
At home
When you return home, keep an eye on your incisions. Some bruising is normal but contact your doctor if you experience increased pain, redness, swelling, bleeding or other draining from an incision, fever, or chills.