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Cardiac Surgeons Introduce Dor Heart Failure Procedure

Cardiac SurgeonsASHLAND, KY — King’s Daughters cardiothoracic surgeons Richard Heuer, M.D.Robert Fried, M.D., andMarcos Nores, M.D., have introduced left ventricular reconstructive surgery to improve cardiac function in heart failure patients.

This surgery, known as the Dor procedure, involves the careful removal of scarred heart tissue and returning the left ventricle to a more normal shape. The goal is to improve heart failure and/or angina symptoms, increase oxygen supply to the heart muscle, and possibly improve the heart’s pumping ability. In about half of patients undergoing the left ventricular reconstruction surgery, mitral valve leaks also are repaired.

“Dor surgery provides substantial advantages for the patients, including a better quality of life, less pain, reduced risk for stroke and slowing down the progression of heart failure,” Dr. Nores says.

The Dor procedure benefits patients who have:

  • had a heart attack that caused an aneurysm/scar in the left ventricle and have heart failure symptoms that are not relieved with medications and lifestyle changes

  • have severe coronary artery disease with symptoms of angina

  • have valve problems that require surgical treatment

  • have ventricular tachycardia

When a heart attack occurs in the left ventricle, heart muscle deprived of oxygen can die and a scar may form. The scarred area can become thin and bulge out, creating an aneurysm. The aneurysm, along with scars and dead heart tissue, are no longer part of the pumping process and cause the heart to work harder. Initially the heart can handle the additional work, but over time, the left ventricle becomes larger than normal and pumps less effectively. In addition, the mitral valve can become disfigured and not close properly, leading to a heart murmur and increasing the risk of stroke.

Nearly five million Americans are living with heart failure, and 550,000 new cases are diagnosed each year, according to the American Heart Association. The most common causes of heart failure are previous heart attacks, high blood pressure, abnormal heart valves, congenital heart defects, severe lung disease and diabetes.

To learn more about the procedure, please call Heuer, Fried, Nores and Associates at (606) 326-9847.

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