Patient selection for LIVE therapy - From clinical indications to
multimodality imaging individual case planning
Abstract
Background LIVE (Less Invasive Ventricular Enhancement) with Revivent
TC™ is an innovative therapy for symptomatic ischemic Heart Failure
(HF). It is designed to reconstruct a negatively remodeled left
ventricle (LV) after an anterior myocardial infarction (MI) by plication
of the scar tissue. Its indications are specific and, as with any other
structural heart intervention, the success of the procedure starts with
appropriate patient selection. We aim to present the indications of the
technique, crucial aspects in patient selection and individual case
planning approach. Methods and Results After clinical evaluation,
transthoracic echocardiography is the first imaging modality to be
performed in a potential candidate for the therapy. However, definitive
indication and detailed case planning rely on late gadolinium-enhanced
cardiac magnetic resonance imaging or multiphasic contrast-enhanced
cardiac computed tomography. These imaging modalities also assist with
relative or absolute contra-indications for the procedure. Individual
assessment is done to tailor the procedure to the specifics of the LV
anatomy and location of the myocardial scar. Conclusion LIVE procedure
is a unique intervention to treat symptomatic heart failure and ischemic
cardiomyopathy after anterior MI. It is a highly customizable
intervention that allows a patient-tailored approach, based on
multimodality imaging assessment and planification.