Patient selection
Any patients suffering from heart failure symptoms with cardiac dysfunction caused by a previous myocardial infarction resulting in increased LV systolic volume and in a discrete, contiguous, non-contractile, (akinetic and/or dyskinetic) scar located in the antero-septal, apical (may extend laterally) region of the left ventricle.
Transthoracic echocardiography (TTE) is utilized to assess for LV dilatation, diminished ejection fraction (EF), LVESVI and LVEDVI, regional wall akinesis or dyskinesis. It is a useful imaging modality to guide further investigation to determine suitability for Revivent TC™ and to plan the LV reconstruction.
Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) gives a higher resolution image, clearly indicating scar thickness, extent and anatomy. It also gives excellent indication of LVESVI, LVEDVI and EF. LGE is the gold standard for scar determination.
4D cardiac computed tomography (CT) scan carried out with a triphasic injection of contrast media is a suitable alternative to CMR for patients unable to undergo the latter.
The following are absolute contra-indications for the LIVE procedure:
The following are relative contra-indications for the LIVE procedure: