enough contraction. Nonviable myocardial muscle mass (NVMMM) implies a distinct, inexpensively reproduced signature (electrocardiography and echocardiography) of several contemporary myocardial performance determinants when compared to viable myocardial muscle mass (VMMM). Ratio between the two in heart failure on a time curve is a determinate of compensatory geometric remodeling of the myocardium. Fick/Frank/Starling describes gas diffusion, fluid and compliance relationships of the myocardium, primarily in systole. Geometric derangement induced by nonviable myocardium (see myocardial infarction) is exponentially impacted and proportional to the weight of the performance determinant measured. Viable/Nonviable myocardial mass fraction is substantially reduced by surgical interventions such as Dor and Batista. Patient evaluation Doctors take a cardiac MRI to determine extent and location of the damage. Occasionally this reveals that the patient may be better suited for biventricular pacing or a defibrillator, but if the cardiologist determines that the Dor procedure is necessary, then the patient must display other symptoms to indicate that they would be a good candidate, including: angina, heart failure, arrhythmias or a combination of the three, large areas of akinesis or dyskensis, ejection fraction of less than forty percent Contraindications include: dysfunctional right ventricle, pulmonary hypertension, dysfunction at the base of the heart, systolic pulmonary artery pressure greater than 60mmHg (in the absence of severe mitral regurgitation) Procedure Surgeons usually perform the Dor procedure following a coronary artery bypass graft (CABG). EVCPP consumes only approximately twenty minutes of the three- to four-hour procedure. To begin a basic remodeling, the surgeon makes an incision at the center of the depressed area on the LV wall and removes blood clots and endocardial scar tissue. To restore the heart to its elliptical shape, an endoventricular suture is put in place and a longitudinal tuck is made to return the cardiac apex from the posterior to the front. The suture also serves as guidance for the patch location. The surgeon then inserts a balloon into the ventricular cavity to ensure correct size and sutures a Dacron patch, deflating the balloon and removing it before complete closure. The non-viable fibrous tissue is pulled over the patch, and surgical glue is occasionally used to complete the closure. When the lesion is placed on the anteroseptoapical wall of the heart, it will include the septum and apex more extensively than the lateral wall. As a result, the suture is placed deeply within the septum, and the new neck of the suture, which