Surgical Restoration of the Postinfarction Dilated Ventricle

Surgical restoration of the failing heart is related to rebuilding cardiac architecture and linked to: (a) understanding that the structure of the failing dilated heart involves changing the normal elliptic shape toward a dilated spherical form; (b) recognizing the anatomic fiber orientation framework and its functional implications; (c) establishing imaging measurement guidelines to determine indications for surgical intervention that focus upon volume and remote muscle evaluation rather than ejection fraction; and (d) summarizing left ventricular restoration results whereby rebuilding normal elliptic configuration improves function, reduces ventricular arrhythmias, alleviates mechanical dyssynchrony, and causes progressive improvement that extends long-term prognosis.