The Contribution of CMR to Patients Undergoing the Surgical Ventricular Restoration (SVR) Procedure; One Center's Experience over Five Years

ABSTRACT

The use of Cardiovascular Magnetic Resonance (CMR) for the interrogation of the cardiovascular system is well established. As surgical techniques evolve seeking to address ischemic cardiomyopathic patients with increasing levels of cardiac functional perturbations, an imaging technique that is sufficiently comprehensive to complement these approaches is obligatory. The utility of CMR is shown for the evaluation of structure, function, morphology, viability, and intramyocardial strain by radio-frequency tissue tagging for patients with ischemic cardiomyopathy who are potential candidates for Surgical Ventricular Restoration (SVR). Using examples from the authors’ experience over the last five years, representing perhaps the longest consecutive application of CMR to this complex patient group, the elements of a complete cardiac interrogation are demonstrated. Future applications for CMR aimed at the ischemic cardiomyopathic patient population are discussed, including applications to measuring diastolic function, stem cell research, and introduction of the concept of an energy model seeking to account for the mechanisms of the observed mechanical efficiency following SVR.

Keywords:

Surgical ventricular restoration procedure, cardiovascular magnetic resonance imaging, ischemic cardiomyopathy, left ventricular dysfunction, dor procedure..