La eficiencia del corazón como bomba esta íntimamente ligada a la estructura y la disposición de sus fibras musculares. Debemos considerar el proceso de remodelado ventricular, tras un daño miocárdico, como un elemento etiopatogénico de la insuficiencia cardiaca. En este contexto, el desarrollo de insuficiencia mitral functional dispara la sintomatología del paciente y empeora su pronóstico. En los últimos años se ha introducido el concepto de restauración ventricular como una nueva aproximación diagnóstica y terapéutica en el paciente con insuficiencia cardiaca. La resonancia magnética se ha convertido en la exploración princeps para el diagnóstico y el seguimiento de estos pacientes. Desde el punto de vista quirúrgico debemos entender el abordaje de estos pacientes como una trilogía: hay que actuar sobre las arterias coronarias, reparar la válvula mitral si hay una insuficiencia al menos moderada, y realizar una reducción del volumen ventricular.
Palabras clave
Insuficiencia cardiaca
Remodelado
Insuficiencia mitral
Cirugía
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