Right heart failure is a poorly understood and often mismanaged disease entity. A leading cause of morbidity and mortality worldwide, right heart failure is in desperate need of new and effective treatment strategies. Ventricular restraint is a novel surgical treatment strategy for left heart failure. The procedure consists of wrapping a synthetic material around the heart to prevent adverse LV dilatation and remodeling. By mechanically constraining chamber enlargement, myocardial wall stress becomes reduced. The PI (Chen) has developed a novel ventricular restraint device capable of applying restraint in an objective and quantified manner. Using an ovine left heart failure model, applied ventricular restraint has been shown to reduce myocardial wall stress and oxygen consumption and reverse the pathological left ventricular remodeling associated with left heart failure.1 The major hypothesis of this proposal is that adjustable and measurable ventricular restraint therapy can be applied selectively to the right ventricle only, and that selective RV restraint will promote RV reverse remodeling as a new treatment strategy for RV failure.
While half a million Americans have right heart failure, there is little to definitively offer patients besides cardiac transplantation. Since restraint therapy has been previously shown to promote reverse remodeling of the left ventricle in left heart failure, we hypothesize that adjustable and measurable ventricular restraint can be applied specifically to the failing right ventricle to engender right heart reverse remodeling. By treating the damaged right heart with ventricular restraint designed for the right heart, our group hopes to provide a realistic treatment option for right heart failure.
|Cevasco, Marisa; Mick, Stephanie L; Kwon, Michael et al. (2013) True external diameter better predicts hemodynamic performance of bioprosthetic aortic valves than the manufacturers' stated size. J Heart Valve Dis 22:377-82|