What Is the Dor Procedure?

A Dor procedure addresses a misshapen left ventricle of the heart to help the heart beat more efficiently. Patients usually need this procedure after a myocardial infarction has created an area of thin, scarred tissue that allows the ventricle to dilate. This forces the heart to work harder to pump the same amount of blood, putting strain on the organ. Over time, complications like heart failure can develop, and the patient’s overall lifespan is typically shortened by the damage.

Before a Dor procedure, the doctor can request some imaging studies of the heart. These include echocardiography to look at the patient’s level of heart function and the current size of the left ventricle. This information is important to have, as it determines whether the patient is a good candidate for the procedure. Some patients may not have problems significant enough to warrant the risks of heart surgery, for instance.

General anesthesia is required for this surgery, which is named for the doctor who developed it in the 1980s. While the patient is on the operating table, the surgeon exposes the walls of the heart and carefully removes dead, scarred tissue from the left ventricle. Using a balloon catheter, the surgeon can confirm that the left ventricle is back to normal size before withdrawing the catheter, sewing a patch into the heart wall, and suturing the incision closed. This prevents a recurrence of thinning along the heart wall by reinforcing it.

Typically, a Dor procedure is performed as part of a Coronary Artery Bypass Graft (CABG) procedure to treat a patient with existing heart problems. It adds some time to both the surgery and recovery time, but may be worth it in some cases for the improvement in patient outcomes. People are likely to live longer after the procedure and may have better heart function, which can protect the entire cardiovascular system as well as dependent organs. Since the patient is already recovering from CABG, the restrictions associated with a Dor procedure are not a significant disruption.

Patients may find it helpful to meet with several surgeons to discuss CABG and a Dor procedure to determine if these treatment options are right for them. Surgeons can also talk about their technique, success rates, and what to expect from recovery. It can be useful to pull together all of this information to make a fully informed decision about how to proceed with treatment for a heart problem.