Experimental Investigations A New Model of Ventricular Plication: A Suturing Technique to Decrease Left Ventricular Dimensions, Improve Contractility, and Attenuate Ventricular Remodeling After Myocardial Infarction in the Rat Heart

Background: The Batista procedure (cardioreduction) is a surgical technique in patients with dilated cardiomyopathy that results in improvement of ventricular function. The purpose of this study was to test a new suturing technique without resection for cardioreduction of myocardial infarct scars in rats. Methods and Results: Myocardial infarction (MI) was induced by occluding the left coronary artery 4 weeks before enrollment. Animals then were randomized to a control (n = 11) or treatment group (n = 11). A pursestring suture was placed within the border zones of the infarcted area and was either tightened (treated) or not (controls). Echocardiography was used to measure left ventricular diameters before, 1 hour, and 6 to 7 weeks after plication. Acutely after plication, end-diastolic length (EDL) decreased from 0.70 ± 0.03 cm to 0.53 ± 0.02 cm, P <.001; end-systolic length (ESL) decreased from 0.51 ± 0.03 cm to 0.23 ± 0.02 cm, P <.001; and fractional shortening (FS) increased from 27.6 ± 1.5 % to 57.6 ± 2.3%, P <.001, whereas controls were unchanged. In control rats EDL increased from baseline at 0.73 ± 0.02 cm to 0.82 ± 0.04 cm at 6 weeks postsurgery, P <.05; ESL increased from 0.54 ± 0.02 cm to 0.66 ± 0.04 cm, P <.005; and FS decreased from 26.9 ± 1.1 % to 19.2 ± 1.2 % at 6 weeks, P <.05. In contrast, at 6 weeks in plicated animals, EDL was significantly less than control