The potential role of ventricular compressive therapy

Early infarct expansion is associated with progressive ventricular dilatation and contractile dysfunction, causing ventricular remodeling and leading to congestive heart failure (CHF). The value of ventricular compressive therapy in established CHF is unclear. Early clinical studies using the Acorn cardiac support device (CSD) have failed to demonstrate a clear benefit, though definitive assessment awaits a well-designed clinical trial comparing isolated CSD placement with optimal medical management. In contrast, the value of prophylactic prevention of infarct expansion has been demonstrated experimentally: early ventricular restraint prevents ventricular remodeling and the attendant CHF.