Cardiology

Surgical Ventricular Resection (SVR) in India: Advanced Heart Failure Treatment

For international patients seeking specialised care, VRH Healthcare facilitates access to India's leading cardiac surgeons and state-of-the-art facilities for SVR.

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What is Surgical Ventricular Resection (SVR)?

Surgical Ventricular Resection (SVR), often referred to as ventricular restoration or the Dor procedure, is a highly specialised open-heart surgery designed to improve the function of a severely weakened heart. It targets patients with advanced heart failure, typically following a major heart attack that has caused significant scarring and enlargement of the left ventricle. The procedure involves carefully removing or reshaping the non-functional, scarred areas of the heart muscle. By reducing the overall size of the ventricle and restoring a more efficient shape, SVR aims to enhance the heart's pumping ability, alleviate debilitating symptoms like breathlessness and fatigue, and ultimately improve the patient's quality of life. VRH Healthcare helps you navigate the options for this complex procedure in India.

Types / Variants of Surgical Ventricular Resection (SVR)

Dor Procedure (Endoventricular Patch Plasty)

Removes scarred tissue, reconstructs the ventricle using a synthetic patch for optimal shape.

Linear Ventricular Repair

Excises scarred tissue, directly sutures healthy heart muscle to restore ventricular integrity.

Exclusion Surgery

Isolates the non-contracting, aneurysmal part of the ventricle from the functional pumping chamber.

Combined Procedures

SVR often combined with coronary artery bypass grafting (CABG) or valve repair for comprehensive treatment.

Your surgeon explains why a particular approach is recommended for you.

Technology & Techniques

In India, Surgical Ventricular Resection (SVR) is performed in advanced cardiac centres utilising cutting-edge technology to ensure precision and patient safety. Key technologies and techniques may include:

Cardiopulmonary Bypass Machine (Heart-Lung Machine)

High-Resolution Intraoperative Echocardiography

Advanced Cardiac Imaging (MRI, CT Angiography for pre-op planning)

Precision Surgical Instruments and Retractors

Sophisticated Anaesthesia Workstations and Monitoring Systems

Dedicated Cardiac Intensive Care Units (CICU) with advanced life support

Blood Conservation Strategies and Autotransfusion Systems

Benefits

**Improved Cardiac Function:** SVR significantly enhances the left ventricle's pumping efficiency, leading to better blood circulation throughout the body.
**Symptom Alleviation:** Patients often experience a marked reduction in severe heart failure symptoms such as breathlessness, fatigue, and swelling, improving daily comfort.
**Enhanced Quality of Life:** By reducing symptoms and improving heart function, SVR can significantly boost a patient's ability to perform daily activities and enjoy a better quality of life.
**Reduced Hospitalisations:** Successful SVR may decrease the frequency of hospital admissions related to acute heart failure exacerbations, offering greater stability.
**Potential for Longevity:** For carefully selected patients, SVR can improve long-term survival rates compared to medical management alone, offering a vital treatment pathway.

Limitations

**Major Surgical Risks:** As an open-heart procedure, SVR carries inherent risks including significant bleeding, infection, stroke, kidney complications, and cardiac arrhythmias.
**Strict Patient Selection:** SVR is not suitable for all heart failure patients. Eligibility depends on specific criteria, including the location and extent of ventricular scarring, and overall health.
**Prolonged Recovery Period:** Patients require an extensive recovery period, often involving several weeks in hospital and months of rehabilitation, impacting immediate return to normal life.
**Does Not 'Cure' Heart Failure:** SVR manages and improves heart failure symptoms and function but does not eliminate the underlying condition, requiring ongoing medical management.
**Variable Outcomes:** The degree of improvement can vary based on factors like the patient's pre-existing health, the severity of heart damage, and the surgeon's experience.

Diagnostics & Pre-Arrival Work-Up

**Echocardiogram (Echo):** To assess heart size, pumping function (ejection fraction), and valve health.

**Cardiac MRI (Magnetic Resonance Imaging):** Provides detailed images of heart muscle, scarring, and ventricular volumes.

**Coronary Angiography:** To identify blockages in coronary arteries that may require simultaneous bypass surgery.

**Electrocardiogram (ECG):** To evaluate heart rhythm and detect any electrical abnormalities.

**Chest X-ray:** To check lung status and overall heart size.

**Blood Tests:** Including complete blood count, kidney and liver function tests, electrolytes, and cardiac biomarkers (e.g., BNP).

**Pulmonary Function Tests (PFTs):** To assess lung capacity, especially important for open-heart surgery.

**Stress Test (if applicable):** To evaluate heart function under exertion.

**Right Heart Catheterisation:** To measure pressures within the heart and lungs.

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Pre-Arrival & Travel Checklist

Medical records and imaging

Passport and medical visa

Pre-surgery instructions (medications, fasting)

Accommodation and airport pickup confirmation

Post-discharge recovery plan and tele-review schedule

How the Procedure is Done (Step-by-Step)

Pre-operative Assessment and Anaesthesia

A thorough final assessment ensures readiness for surgery. General anaesthesia is carefully administered, placing you in a deep, pain-free sleep for the entire procedure.

Sternotomy and Cardiopulmonary Bypass

A precise incision is made down the chest, and the breastbone is gently opened. The heart-lung machine then takes over, circulating blood and oxygen, allowing the heart to be still.

Ventricular Resection and Reconstruction

The surgeon carefully identifies and excises the scarred, non-functional heart muscle. A synthetic patch or direct suturing is used to reshape the left ventricle, restoring its optimal geometry.

Weaning from Bypass and Closure

Once reconstruction is complete, the heart is gradually restarted, and the patient is weaned off the heart-lung machine. The chest incision is then meticulously closed, and drains are placed.

Post-operative Intensive Care

Dr Shiv Kumar Choudhary is Executive Director CTVS at Fortis Escorts Heart Institute, New Delhi with 32+ years’ experience in complex aortic, valve, transplant and cardiac surgery.

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Expected Outcomes & What Success Means

Improved Pumping Efficiency: The heart's ability to pump blood effectively is enhanced, leading to better circulation.

Reduced Heart Failure Symptoms: Patients typically experience less shortness of breath, fatigue, and swelling, improving comfort.

Enhanced Physical Capacity: Many find they can engage in more daily activities with greater ease and less exertion.

Better Quality of Life: Overall well-being and satisfaction with life often improve significantly post-surgery.

Potential for Reduced Hospitalisations: The improved heart function may lead to fewer emergency visits for heart failure.

Increased Exercise Tolerance: Patients may gradually regain the ability to perform light to moderate exercise comfortably.

Recovery & Follow-Up Timeline

Immediate Post-operative (CICU)Intensive monitoring of vital signs, pain control, and respiratory support. Early, gentle mobilisation with assistance begins within 24-48 hours.

Hospital Ward Recovery (Days 3-14)Transition from CICU to a regular ward. Focus on increasing mobility, wound care, medication management, and initial cardiac rehabilitation exercises.

First Few Weeks Home (Weeks 2-6)Rest is crucial, alongside light activities. Avoid heavy lifting and strenuous exertion. Regular follow-up appointments with your cardiologist are essential.

Intermediate Recovery (Months 2-3)Continued participation in a structured cardiac rehabilitation programme is vital. Gradual increase in activity levels under medical guidance.

Long-term Rehabilitation (Months 3+)Ongoing lifestyle modifications, medication adherence, and regular check-ups to maintain optimal heart health and prevent complications.

Fitness to fly and activity limits are centre-specific.

How Quickly Can I Start?

Step 1

Second Opinion

12-48 hours

Typically received after sharing medical reports.

Step 2

Scheduling

1-2 working days

Depending upon the availability of the specialist

Step 3

Visa Invitation Letter (VIL)

1-2 working days

issued promptly to support your medical visa application.

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Costs & What Affects Your Estimate

Choice of hospital (e.g., private super-specialty vs. large multi-specialty hospital)Experience and reputation of the cardiac surgical teamLength of hospital stay, particularly the number of days in the ICUComplexity of the SVR procedure and any co-existing heart conditionsNeed for additional procedures, such as coronary artery bypass grafting (CABG)Type and cost of any specific medical devices or implants usedPre-operative diagnostic tests and post-operative rehabilitation requirementsDevelopment of any complications requiring extended treatment or interventionsChoice of room category (e.g., private room vs. shared ward)Inclusion of international patient services (e.g., interpreter, dedicated coordinator)

This page provides an overview of typical costs and influencing factors. A personalised cost estimate is shared after a medical review of your reports—please contact us to request your individual estimate.

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How VRH Healthcare Helps

VRH Healthcare is not a hospital. We act as your medical facilitation and patient-navigation partner, helping you make informed decisions and move smoothly through care in India.

Independent second opinions (even if you already have an estimate)

Review of medical records and reports

Shortlisting appropriate hospitals and surgeons

Appointment scheduling and care timelines

Medical visa invitation letters (VILs)

Airport pickup, local transport, and accommodation near hospitals

Language interpreters and on-ground assistance

Indicative cost estimates based on medical review

Post-discharge tele-follow-ups

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International Patient Services

Medical visa invitation letters

Airport transfers and local transport

Accommodation near the hospital

Language interpreters (Arabic, Russian, French, English)

Appointment coordination and updates for family

Post-discharge follow-ups via tele-consultation

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Your Care Journey with VRH

A simplified step-by-step guide to your treatment experience.

1Step 01

Share medical reports

2Step 02

Receive an expert second opinion and indicative estimate

3Step 03

Plan travel, visa, and appointments

4Step 04

Treatment with on-ground coordination

5Step 05

Discharge and ongoing tele-follow-ups

Step 01

Share medical reports

Step 02

Receive an expert second opinion and indicative estimate

Step 03

Plan travel, visa, and appointments

Step 04

Treatment with on-ground coordination

Step 05

Discharge and ongoing tele-follow-ups

You can request a second opinion at any stage—even if you already have an estimate.

Where We Serve: Countries We Support

Middle East

Saudi ArabiaOmanBahrainUAEYemenIraq

Language support, visa assistance, and coordinated care planning for cardiac surgery including SVR.

Africa

NigeriaKenyaTanzaniaEthiopiaGhanaAngolaMozambiqueUgandaSudanChadGuinea

Support for diagnostics review, travel planning, and post-treatment follow-up.

Central Asia & CIS

KazakhstanUzbekistanKyrgyzstanTajikistanRussia

Interpretation services and hospital coordination for surgical care.

South Asia

BangladeshNepalMaldivesSri LankaAfghanistan

Quick access to opinions, scheduling, and continuity of care.

U.K. & USA

Second opinions, cost-sensitive planning, and post-return tele-follow-ups.

Other Countries

Customised support based on individual travel and care needs.

Frequently Asked Questions

Who is a suitable candidate for Surgical Ventricular Resection (SVR)?

SVR is typically considered for patients suffering from severe heart failure, often as a consequence of a previous heart attack that has led to a large, non-contracting scar in the left ventricle. These patients usually experience persistent, debilitating symptoms despite receiving optimal medical therapy. A comprehensive evaluation by a multidisciplinary cardiac team, including advanced imaging and functional tests, is crucial to determine if SVR is the most appropriate and beneficial treatment option for their specific condition.

What are the potential risks associated with SVR surgery?

As a major open-heart surgical procedure, SVR carries inherent risks. These can include significant bleeding, infection at the surgical site, stroke, kidney dysfunction, and cardiac arrhythmias. There is also a risk of persistent heart failure symptoms or the need for further cardiac interventions. Your cardiac surgeon will conduct a thorough risk assessment and discuss all potential complications in detail, ensuring you understand the balance between risks and the anticipated benefits for your individual health profile.

How long is the hospital stay and overall recovery period for SVR?

Patients undergoing SVR can typically expect a hospital stay of approximately 7 to 14 days, which includes several days in the Cardiac Intensive Care Unit (CICU) for close monitoring. The initial recovery phase at home usually spans several weeks, during which light activities are gradually resumed. Full recovery and a return to most normal activities, often supported by a structured cardiac rehabilitation programme, can take anywhere from 3 to 6 months, depending on individual progress and overall health.

Will I need ongoing medication after SVR surgery?

Yes, it is highly probable that you will continue to require medication after SVR surgery. While SVR aims to significantly improve heart function and alleviate symptoms, it is part of a comprehensive, long-term management strategy for heart failure. Medications typically include those to manage blood pressure, prevent blood clots, control heart rhythm, and further support overall cardiac health. Adherence to your prescribed medication regimen is vital for optimising long-term outcomes.

Can SVR be performed using minimally invasive techniques?

Surgical Ventricular Resection is traditionally performed as an open-heart procedure, which necessitates a sternotomy (an incision through the breastbone) to provide the surgeon with direct and clear access to the heart. Due to the complexity of reshaping and reconstructing the left ventricle, SVR is not typically amenable to minimally invasive techniques. Your cardiac surgeon will explain the standard surgical approach and why it is considered the most effective method for this specific procedure.

What kind of long-term follow-up is required after SVR?

Long-term follow-up after SVR is crucial for monitoring your heart health and ensuring the best possible outcomes. This typically involves regular consultations with your cardiologist, periodic echocardiograms to assess heart function, and blood tests. Participation in a cardiac rehabilitation program is highly recommended to help you regain strength and adopt heart-healthy lifestyle changes. VRH Healthcare can assist in coordinating post-discharge tele-follow-ups with your treating team in India.

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