Inferior wall restoration: Anatomic and surgical considerations

Lorenzo Menicanti, Vincent Dor, Gerald D. Buckberg, Constantine L. Athanasuleas, Marisa Di Donato

Research output: Contribution to journalArticlepeer-review


Congestive heart failure that results from inferior infarction is caused by a triangular change in ventricular geometry, which involves the septum, lateral wall, and base supplied by the right coronary artery. The extent of damage is determined by the anatomic distribution of coronary blood flow. Mitral insufficiency is accentuated from damage to the basal region, especially when the occluded right coronary vessel has multiple inferior branches and wraps around the apex. Three methods of repair are described, and include direct restoration without a patch, patch repair of the triangular scar, or use of a retriangulation suture in ventricles with trabecular scar to imbricate the noncontractile region to restrict patch size. This triangular reduction in size mirrors the design concept for suture described by Fontan in anterior infarction, which produces an oval apex. Early results in relation to left ventricular end systolic volume index and ejection fraction are defined.

Original languageEnglish
Pages (from-to)504-513
Number of pages10
JournalSeminars in Thoracic and Cardiovascular Surgery
Issue number4
Publication statusPublished - 2001


  • Congestive heart failure
  • Direct closure
  • Inferior restoration
  • Mitral insufficiency
  • Patch repair
  • Retriangulation suture

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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