Passive constraint and new shape-change devices for heart failure.
Lessons learned from ventricular remodeling procedures have shown that Laplace mechanics, whereby mural tension is related to ventricular diameter, may be beneficially applied to the left ventricle (LV). Recently developed devices, predicated on the Law of Laplace, are directed at interrupting the heart-failure cascade without removing functioning myocardium. The Acorn cardiac support device is a polyester-mesh jacket placed snugly around the heart to provide end-diastolic support and prevent LV dilation. The Myosplint device uses transmural tension members to bisect the dilated LV to create a bilobed LV with decreased mural tension in each cavity. Preclinical and early clinical data with both devices appears promising and may offer a new surgical alternative for patients with worsening heart failure.
Kaplon
Richard
R
Cardiac and Thoracic Medical Group, Mercy General Hospital, Sacramento, CA 95819, USA.
Lombardi
Pierluca
P
D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery*; D006352:Heart Ventricles / Q000473:pathology; D006353:Heart-Assist Devices; D006801:Humans; D009200:Myocardial Contraction; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling