SAVER Heart Failure Surgery

What Is SVR? 

Heart failure is often caused by ischemic heart disease that causes enlargement of the heart's main pumping chamber, the left ventricle. SVR means Surgical Ventricular Restoration. This surgery is for people who have had a heart attack in the anterior (front) area of their heart.
     SVR removes pieces of damaged heart muscle that do not move properly when the heart beats. This "down-sizes" the heart back to a more normal size and shape.

Who Can Have SVR?

People with CHF who have fairly large dysfunctional areas of heart muscle (over 35%); and have adequate muscle function in other areas of the heart (inferior and lateral); with an ejection fraction less than 35%; and with left ventricular end-systolic volume more than 60 ml/m2.

How is SVR Done?

The dysfunctional areas of heart muscle are identified before surgery. Echo or MUGA is used to estimate the area of dysfunctional heart muscle, and to measure how well the rest of your heart muscle is working. MRI and cath, or MUGA measures ventricle size.
     After cutting open the heart's left ventricle, damaged areas are removed and stitches used to reshape the ventricle. The now-oval opening in the ventricle is repaired and closed with a patch.
     Any needed mitral valve repair is done and any restoration of blood flow, like CABG (bypass surgery), is also done during the same surgery.

How Is SVR Different From the Batista Procedure?

The Batista procedure reduces heart size by removing a section that may include some good heart muscle. SVR specifically removes only parts of the heart muscle that don't contract properly when the heart beats.

Why Use the CorRestore System During SVR?

The CorRestore System includes a heart patch of tissue from a cow's heart with a ridged inner ring that is flexible, surrounded by a shaped outer rim. This patch was designed to fill the irregular contours of the thick-walled parts of the heart usually still damaged after a heart attack followed by angioplasty.
     The patch's features guard against leaking. The sizer tool also makes it faster and easier to tell what size patch to use.

What Are the "Proven" Benefits of SVR?

A 3-year trial of 662 SVR patients has been completed. The overall 3-year death rate was 11% and readmission to the hospital with heart failure was only 11%. Annual hospital admission rate for class 3 and class 4 CHF patients is usually more than 40%, and 24% are admitted at least twice each year.
     After surgery, ejection fraction rose from 30% to 40%, and left ventricular end systolic volume went down from 96 to 62 ml/m2. In the 355 patients for whom heart class was reported at the last follow-up, 91% were improved or free of congestive heart failure symptoms. At 3 years, survival was 89%.

 

Left ventricle with non-beating areas
non-contracting_heart_area

The left ventricle is opened
incision_made_in_heart

Feeling the heart to know where to put the patch
palpating_the_heart

Preparing for the patch with sutures
Sutures-Preparing_for_the_patch

The patch sizer - patches come in 3 different sizes
patch_sizer

Patch sizer being used
patch_sizer_in_heart

CorRestore patch
CorRestore_patch

CorRestore patch - flip side
CorRestore_patch-flip_side

Patch being prepared for sewing in place
patch_being_sewn_in_place

Patch in place and being securely fastened
patch_in_place

Final sewing of patch to heart
patch_in_place_2

All done
closed_ventricle

All information on this site is opinion only. All concepts, explanations, trials, and studies have been re-written in plain English and may contain errors. I am not a doctor. Use the reference information at the end of each article to search MedLine for more complete and accurate information. All original copyrights apply. No information on this page should be used by any person to affect their medical, legal, educational, social, or psychological treatment in any way. I am not a doctor. This web site and all its pages, graphics, and content copyright © 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004 Jon C.

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