|Scar Tissue in the Heart Caused by a
Heart Attack (Myocardial Infarction)
Cardiac Sewing for Heart Failure Patients
One of the biggest known causes of Heart Failure is Coronary Heart Disease (CHD). CHD is the build up of atheroma (fatty deposits) occur in the Coronary Arteries. If this fatty deposit ruptures or becomes so large that it completely blocks off a Coronary Artery blood can no longer get to all of the heart muscle.
This is the process commonly known as a Heart Attack and if the blood supply to the heart muscle is not returned the heart muscle will waste (die) and be replaced by non-contracting scar tissue.
The damaged ‘scar tissue’ does not have the same properties as healthy heart muscle. Over time the continued force of blood inside the heart pushing on it, as the rest of the heart contracts, causes it to stretch and the heart to become remodelled.
Imagine holding a stress ball in your hand and squeezing, the areas that your hand covers is like the healthy heart the areas that are not covered do not ‘contract’ are the scar tissue and the force pushes it out. Over time, with hundreds of contractions, this permanently stretches the damaged area of the heart.
|Over Time the Heart has become
Stretched the Cavity Dilated –
Reducing Pumping Capability
The stretching of the heart means that over time the chambers in the heart enlarge – become dilated. These enlarged chambers are less efficient at pumping blood and eventually fail to meet the demands of the rest of the body. When a heart can no longer cope with the needs of everyday life, the patient is said to be in heart failure. The process continues in a downward cycle with a failing heart leading to a worsening Cardiomyopathy and vice versa.
Treatment using Cardiac Sewing
Cardiac Sewing is a pioneering surgery being trialled as a treatment option for Dilated Cardiomyopathies of this nature.
The first UK Trial of Cardiac Sewing was carried out in Kings College Hospital (London) by Professor Olaf Wendler on Sevket Gocer a 58 year old man who suffered with heart failure as a result of a previous heart attack. If the trials prove to be successful then Cardiac Sewing could be widely used in the treatment of such heart disease.
A wire, with anchors each end, was passed through either end of the damaged tissue and pulled together closing off the damaged part of the heart and decreasing the size of the Ventricular cavity. The surgery is performed on a beating heart which reduces some of the risks associated with other invasive heart surgeries.
|Image Courtesy of http://www.bbc.co.uk/news/health-24579402|
The theory is that the reduced sized Ventricular cavity will pump more efficiently. This will work two fold – firstly by improving the stroke volume (blood pumped with each beat) and secondly by slowing the downward spiral of worsening dilation and worsening heart failure.
In the case of Sevket Gover, his Ventricular cavity was reduced by a quarter in size and it was said that his heart function ‘Improved Significantly. I sincerely hope that the benefits continue and future trials show similar levels of improvement.
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Image courtesy of Salvatore Vuono / FreeDigitalPhotos.net