Renewal of left ventricular torsion after modified surgical anterior ventricular restoration.
OBJECTIVE
We present a case of surgical anterior ventricular restoration for ischemic cardiomyopathy performed by a modified surgical technique, in which we obtained the renewal of left ventricular torsion.


METHODS
We set a modified restoration technique utilizing a strip patch with the aim to realign fibers displaced by postinfarction fibrosis. We studied left ventricular basal and apical rotation and global torsion preoperatively and postoperatively by means of two-dimensional speckle-tracking echocardiography.


RESULTS
Although torsion was completely upset before the operation, due to the remodeled ventricular geometry and to the loss of apex contraction, we demonstrated the renewal of twist motion at the early postoperative assessment, with the regaining of physiologic characteristics and morphology.


CONCLUSIONS
As torsion is a specific movement of a healthy heart, due to fiber disposition and orientation through the ventricular wall, its early renewal could be considered an indirect but valuable proof of fiber realignment with the described novel technique.
Cardiovascular Department, Heart Surgery Unit, Italy. cirillo-marco@poliambulanza.it
Marco
M
Cirillo
Emmanuel
E
Villa
Marco
M
Campana
Giovanni
G
Troise
D000368:Aged; D006348:Cardiac Surgical Procedures; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D018618:Echocardiography, Doppler, Color; D005260:Female; D005355:Fibrosis; D006801:Humans; D009200:Myocardial Contraction; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D009206:Myocardium / Q000473:pathology; D012399:Rotation; D014102:Torsion Abnormality / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D054159:Torsion, Mechanical; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling