Anterior and inferior segment ventricular restoration apparatus and method

Abstract

The symptoms of congenital heart failure are addressed in this surgical procedure for mounting a patch in the ventricle of the heart to reduce ventricular volume. Placement of the patch is facilitated by palpating a beating heart to identify akinetic, although normal appearing, tissue. An apical patch having an oval configuration facilitates return of the heart to a normal apical shape which enhances muscle fiber efficiency and a normal writhing pumping action. An inferior patch having a triangular configuration can also be used. The patches include a semi-rigid ring, and a circumferential rim to address bleeding. Patch placement is further enhanced by creating a Fontan-type neck and use of pledged sutures. Intraoperative vascularization and valve replacement is easily accommodated. Increased injection fraction, reduced muscle stress, improved myocardial protection, and ease of accurate patch placement are all achieved with this procedure.

1 . A ventricular patch adapted for placement relative to the inferior wall of the heart, comprising: 
 a sheet of biocompatible material having a generally planar configuration in the shape of a first triangle;    a continuous ring fixed to the sheet and having the shape of a second triangle geometrically similar to the first triangle;    the ring defining a central region of the patch interiorly of the ring and a circumferential region of the patch exteriorly of the ring; and    the circumferential region of the patch having a generally constant width around the central area of the patch.    
     
     
         2 . The ventricular patch recited in  claim 1 , wherein; 
 the first triangle has a base with a length and the ratio of the constant width of circumferential region to the length of the base is in a range between 1 and 2.    
     
     
         3 . A method for restoring the ventricular architecture of a heart having an anterior wall and an inferior wall, comprising the steps of: 
 creating an incision in the inferior wall of the heart to expose an inner surface of the ventricle of the heart;    forming a suture line around the inner surface of the inferior wall;    providing a ventricular patch; and    sewing the ventricular patch to the inner surface of the inferior wall along the suture line to restore the ventricular architecture of the heart.    
     
     
         4 . The method recited in  claim 3 , wherein the providing step includes the step of: 
 forming the ventricular patch to include a sheet of biocompatible material and a continuous ring fixed to the sheet.    
     
     
         5 . The method recited in  claim 3 , wherein the creating step includes the steps of: 
 creating the incision in a non-contracting region of the inferior walls,    opening the incision to expose an inner surface of the heart, the contracting region being separated from the non-contracting region by a line of separation.    
     
     
         6 . The method recited in  claim 5 , wherein the forming step includes the step of: 
 forming the suture line generally along the line of separation.