Reshaping the Heart May Ease Heart Failure

Oct. 5, 2004 -- A new surgical approach that reshapes damaged hearts may pay off in the long run for some people with advanced heart failure, according to a new study.

Researchers found the technique, known as heart restoration, helped prolong life and improve the function of the heart in people with severe heart failure.

Heart failure occurs when the heart muscle becomes damaged and is no longer able to pump enough blood to meet the body's needs. In many cases, the main pumping chamber of the heart, the left ventricle, has swelled due to damage caused by a heart attack.

Heart failure is often treated with medication to control symptoms or treat problems related to the heart failure. Surgery is also used to bypass damaged parts of the heart in an attempt to restore blood flow and improve pumping function. Heart transplantation is another option for the sickest patients.

But heart restoration surgery involves identifying and pulling the healthy heart tissue surrounding the damaged areas together and restoring the left ventricle to a more normal shape.

"The normal heart is elliptical and shaped like a football, while the dilated heart is spherical in shape, like a basketball. The surgical procedure alters size and shape to make the dilated basketball-shaped heart smaller and restore the more normal football shape," says researcher Gerald D. Buckberg MD, of the UCLA Medical Center in Los Angeles, in a news release.

Restoring the Heart to a Normal Shape

In the study, which appears in the Oct. 6 issue of the Journal of the American College of Cardiology, researchers followed the experience of nearly 1,200 heart failure patients who had had the restoration procedure between 1998 and 2003.

Two-thirds of the participants had advanced heart failure (known as functional class III or IV) at the start of the study.

Buckberg says typically 70% to 80% of people with advanced heart failure do not survive more than three years.

But in this study, researchers found that 70% of class III and 50% of class IV heart failure patients who had the restoration procedure were still alive.

The overall survival rate for those who had the reshaping surgery was nearly 70%.

They also found that the heart's pumping ability improved by an average of 10% after the surgery and swelling of the pumping chamber was significantly reduced.

Researchers say the results suggest that this new approach to treating heart failure deserves further study. But they also point out that the effectiveness and safety of the restoration procedure have not been directly compared to other, more commonly used surgical treatments for heart failure.