Engineering Support in Surgical Strategy for Ventriculoplasty

Endoventricular patch plasty, called the Dor procedure, is performed as a heart reconstruction for the surgical treatment of the patients with severe heart failure associated with anteroapical large myocardial infarction. The authors have been establishing a new engineering method for the individual simulation of operational procedure in order to determine the optimal left ventricular size and shape and to estimate the volumetric reduction after the surgical ventricular restoration in each patient. In this study, three individual ventricular shapes were fabricated by numerically resampled data which were obtained from the diagnostic magnetic resonance imaging in each subject. Prior to the fabrication of the models, epi- or endocardial envelope curve was outlined without papillary muscles or tendinous cords in each end-diastolic and end-systolic phase for the compatible reference in echocardiogram, computed tomography or magnetic resonance imaging investigations. And the mechanical silicone rubber models were made by the use of female moulding for the discussion of each subject among surgeons. In this paper, we examined a methodology for the simulation of ventriculoplasty by using a silicone rubber model and evaluated the capability of quantitative expression of ejection fraction.