Cardiac Restoration and Remodeling Procedures

Cardiac restoration and remodeling procedures — including ventricular aneurysmectomy, surgical ventricular restoration (SVR), partial left ventriculectomy (PLV), and intracardiac/patch repairs — are addressed for patients with severe, refractory congestive heart failure (e.g., EF ≤30% undergoing CABG), ischemic dilated cardiomyopathy with akinetic/dyskinetic segments, and select candidates as a bridge to transplant. Coverage is limited: SVR and PLV are largely considered experimental/investigational with insufficient evidence of improved clinical outcomes (SVR showed no added benefit when added to CABG in trials), coverage is subject to the member’s benefit plan and state rules, and the aneurysmectomy±SVR/PLV exception is confined to individuals undergoing CABG for severe, unresponsive CHF with EF ≤30%.

"Ventricular aneurysmectomy (ventricular aneurysm repair) performed with or without SVR or PLV when done concomitantly with coronary artery bypass graft (CABG) for severe, unresponsive congestive he..."