Certain heart conditions, including a heart attack, may contribute to an enlarged heart. In these instances, a doctor may recommend left ventricular reconstructive surgery to prevent further complications.
Left ventricular (LV) reconstructive surgery is a type of ventricular resection procedure that treats an enlarged heart, which is known as cardiomegaly. Resection is the medical term for surgically removing part of an organ.
LV reconstructive surgery is a type of open-heart surgery used in conjunction with other treatments and lifestyle changes to help prevent heart failure.
Learn more about why a doctor might recommend this surgery, what you can expect during the procedure, the recovery process, and your overall outlook.
The overall goal of an LV resection is to help treat or prevent heart failure from an enlarged heart by removing scar tissue to improve blood circulation. This procedure may also remove aneurysms, which are bulges in the artery walls.
Sometimes, a heart attack or cardiomyopathy can leave behind scar tissue in the left ventricle. Over time, this can build up, increasing the size of your heart and also making it more difficult for the heart to pump blood as it should.
Decreased function from heart enlargement can eventually lead to heart failure. While LV reconstructive surgery may help reduce this risk, doctors don’t consider the procedure a cure. You will need to follow other treatment and management recommendations from a doctor.
LV reconstructive surgery is a major surgery performed in a hospital. Most times, a doctor will recommend you arrive the day before the procedure to allow time for testing and preparation.
Presurgical prep
About a week before your surgery, a doctor will order blood and urine tests, as well as imaging tests of your heart. They will provide you with final instructions before the surgery, such as any medication modifications, bathing the night before, and removing any piercings from your torso.
Day of surgery
Before your surgery, a doctor will place you under general anesthesia, so you sleep during the LV resection. It’s important that you don’t have any fluids or food after midnight on the day of the surgery to help prevent vomiting.
During the procedure, a heart surgeon will complete the following steps:
- First, they will temporarily stop your heart and place you on a heart-lung machine, so you continue to get blood during the procedure.
- Next, they will make an incision in your chest measuring
6 to 8 inches , in order for them to access your heart. - Once the surgeon opens your heart, they will remove scar tissue from the left ventricle and any aneurysms they might find.
- During the last step, your surgeon will reshape the heart so it can pump blood more efficiently.
If a doctor has also ordered a coronary bypass, the surgeon will complete this procedure at the same time. This will also increase the total amount of time you’re in surgery.
Postsurgical recovery
Once your LV resection is complete, hospital staff will take you to a recovery room. On average, you should expect to stay in the hospital for 3 to 5 days, barring any complications.
The recovery time for LV reconstructive surgery depends on whether any complications develop, as well as your overall health.
After your hospital stay, a doctor will provide detailed home care instructions. As with any type of open-heart surgery, you should expect your total recovery time to last for several weeks.
A doctor will recommend you don’t drive for
During your recovery from LV reconstructive surgery, it’s normal to feel fatigued. You may also have a reduced appetite for a few weeks. While you may experience pain at the incision site, you should call a doctor if you notice redness, lumps, or discharge.
Before undergoing LV reconstructive surgery, a doctor will go over all the possible risks. These include signs of bleeding, infection, or problems at the site of the incisions.
Potential
- fever — call a doctor if it reaches above
100°F (38°C) twice within a 24-hour period - infection
- bleeding
- swelling or redness at the site of your incisions
- pain
- blood clots
- irregular heartbeat (arrhythmia)
- pneumonia
Having other chronic conditions, such as diabetes and kidney disease, may
Other
- appetite loss
- mood swings
- depression
- sleeping difficulties
- constipation
- short-term memory problems — can last up to
one year
The average 5-year survival rate for people living with heart failure is estimated to be
While the exact outlook following LV reconstructive surgery is highly individual, one 2019 study of 109 people who had the procedure may offer some clues.
Researchers found that the 5-year average survival rate was 71.9%, which is higher than the average for those living with heart failure more generally. The 10-year survival rate was 48.1%, and the 15-year rate was 26.2%. The average patient age was about 61 years old.
Another 2019 study of a smaller group of 34 people with end stage heart failure estimated the average 5-year survival rate after LV reconstructive surgery was
Separately, a 2022 review and meta-analysis estimated the 30-day average mortality rate following ventricular reconstruction to be
While more studies are needed, current research does underscore the possible life-extending effects of LV reconstructive surgery. In addition to surgery, a doctor will recommend other strategies for preventing heart failure, such as a healthy diet and regular exercise.
Left ventricular (LV) reconstructive surgery is a type of ventricular resection used in the treatment and prevention of heart failure. The goal is to remove excess scar tissue and reduce the size of your heart back to its typical state, so it can pump blood more effectively.
Overall, LV resection has a positive success rate, and it may extend your lifespan. This isn’t the only strategy used to treat or prevent heart failure, though, so it’s important to keep seeing a doctor and follow their recommendations for a heart-healthy lifestyle.