During a heart attack, the blood and oxygen (O2) flow to the heart muscle is blocked (ischemia). As a result, the heart muscle is damaged (infarct). The Left Ventricular Reconstructive Surgery or Dor Procedure may be a treatment option for patients whose left ventricle has been damaged by a heart attack. To understand this surgery, it is helpful to know how the heart works.
The interior of the heart is composed of valves...
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The heart is about the size of a closed fist. It pumps blood to the lungs and to all the body tissues. The heart has four chambers. The two upper, thin-walled chambers are the right atrium and left atrium. The two larger, more powerful chambers are the right ventricle and left ventricle. The right heart chambers receive blood from the body and pump it to the lungs where it picks up O2. The left atrium receives this oxygen-rich blood from the lungs and sends it to the left ventricle. The ventricle then pumps the blood to all parts of the body by way of the aorta.
When a heart attack affects the left ventricle, its ability to pump blood to the body is decreased. To make up for the ventricle's decreased ability to pump, the heart works harder, may pump at a faster rate (ventricular tachycardia) and may become enlarged.
The damaged area on the left ventricle can also become thin and scarred. This may cause an aneurysm or out-pouching of the heart muscle in that area. All of these changes may eventually lead to heart failure.
The Dor procedure is not for all heart failure patients. It is most often an option for those who have had a heart attack with LV damage and have:
During surgery, an incision is made into the heart muscle. The damaged area or aneurysm is removed. Then the area is then closed with rows of sutures arranged in circle. These sutures draw the heart muscle together- like a draw- string.
As a result the ventricle pumps more effectively and goes back to a more normal size.
