Reviews

Criteria of eligibility of patients with ischemic cardiomyopathy for revascularization and other surgical procedures

N.D. Oryshchyn 

Danylo Galyckyi Lviv National Medical University, Ukraine

Lviv Regional Centre of Cardiology, Ukraine  

The aim of this review is to summarize contemporary approaches to the management of ischemic cardiomyopathy taking into consideration myocardial viability and geometric changes of left ventricle (LV). Information about methods of viability assessment and their importance before revascularization in patients after myocardial infarction is presented. Viability assessment is essential for management of ischemic cardiomyopathy; identification of sufficient amount of viable myocardium predicts beneficial effect of revascularisation. Methods of LV remodeling assessment and value of ventricular reconstruction in patients after myocardial infarction are discussed. Patients with extensive LV remodeling, even with sufficient amount of viable myocardium don’t have benefit of revascularization: increased LV volume is a negative predictor of myocardial function recovery. In patients with LV dilatation assessment of geometric indexes is needed to make decision about volume reduction surgery, which is more effective at the early stages of ischemic remodeling.

Key words: ischemic cardiomyopathy, remodeling, viability, imaging, ventricular reconstruction.