Tratamiento quirúrgico de la insuficiencia cardiaca. Restauración ventricular y cirugía de la válvula mitral

The efficiency of the heart as a pump is intimately linked to the structure and function of heart muscle fibers. The process of ventricular remodeling that occurs following myocardial damage must be regarded as an etiopathologic factor in heart failure. In this situation, the development of mitral regurgitation triggers symptoms and worsens prognosis. In recent years, the technique of surgical ventricular restoration has been introduced as a novel diagnostic and therapeutic approach in patients with heart failure. Magnetic resonance imaging has become the principle exploratory technique for diagnosis and follow-up in these patients. From a surgical point of view, we must adopt a three-pronged approach to these patients: the coronary vessels must be dealt with, the mitral valve must be repaired if there is at least moderate regurgitation, and ventricular volume must be reduced.