Initially described by Dor in 1989, endoventricular patch plasty (Dor procedure) is used to reduce left ventricular (LV) volume after myocardial infarction (MI) and subsequent LV remodeling.  Briefly, the infarct is incised and a purse-string suture (Fontan Stitch) is used to reduce the circumference of the aneurysm "neck".  A patch of either autologous or synthetic material is then sewn to the edge of the aneurysms neck thereby reducing LV volume.

The Dor procedure can be performed safely.  However, the NIH-sponsored Surgical Treatment for Ischemic Heart failure (STICH) trial recently found no difference in composite outcome between coronary bypass (CABG) and CABG plus Dor procedure.  The authors speculated that improved systolic function was balanced by worsened diastolic function.  On the other hand, even if pump function is not improved, the Dor procedure may have important effects on stress, strain and contractility in the infarct borderzone (BZ)