Montefiore Einstein Center for Heart and Vascular Care – Surgical Services - Ventricular Remodeling Surgery - New York

Surgical Ventricular Reconstruction (SVR)

Surgical ventricular reconstruction (SVR) reduces the size of a patient's failing, enlarged heart to ensure that blood is pumped out of the heart, and through the body efficiently enough to allow them to participate in a full, active life.

In a healthy patient, oxygen-rich blood returning from the lungs is pumped through the heart and to the body. In 25 percent of heart attack patients, the left ventricle dilates from its natural football shape into a rounder, basketball shape. This new shape interferes with the heart's ability to contract strongly enough to push the returning blood through the heart. Instead, blood pools in the lungs causing a variety of symptoms that typically compromise quality of life:

  • Fatigue
  • Waking up in the middle of the night short of breath
  • General difficulty catching their breaths
  • Rapid heart beat
  • Chest pain

During the SVR procedure, the cardiothoracic surgeon will reshape the patient's heart so that it can contract more effectively and restore a free flow of oxygen-rich blood throughout the body. Following the procedure, patients who were once winded by their favorite activities, from gardening to golf, can return to these activities free from chest pain and shortness of breath.

Pioneering SVR at Montefiore Einstein

Montefiore Einstein Center for Heart and Vascular Care is a national leader in surgical ventricular reconstruction. SVR has a greater than 95 percent success rate. Robert Michler, MD, Montefiore Einstein's Cardiovascular and Thoracic Surgery Department Chairman, was among the first surgeons in the United States to perform SVR as part of the Surgical Treatment for Ischemic Heart Failure (STICH) trial sponsored by the National Heart, Lung and Blood Institute(NHLBI). Currently, Dr. Michler is the chairman of the Surgical Therapy Committee for the STICH trial. This trial tests the most effective procedures for treating patients with ischemic heart failure. By helping to pioneer the SVR procedure, Dr. Michler and his team are nationally recognized as innovative leaders in ventricular reconstruction.

Heart-Lung Bypass Surgery

Prior to performing reconstructive heart surgery, patients generally receive coronary artery bypass surgery. The patient is put on a heart-lung bypass machine. The deoxygenated blood is collected in the right atrium through a tube and routed to the heart-lung machine. During the transition to heart-lung bypass surgery, patients are given a temporary blood thinner to prevent clots. Once oxygenated blood is redistributed throughout the body, the surgeon will turn off the ventilator and stop the heart with an injection of a high potassium electrolyte solution.

Surgical Ventricular Reconstruction

At the start of the SVR procedure, the surgeon will make an incision into the heart to distinguish scarred tissue from healthy muscle. The surgeon then will reshape the heart by reuniting healthy tissue around a balloon shaper in a manner that excludes scarred tissue like a pleat. This means only strong, healthy muscle is involved in contracting the heart..