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Ann Thorac Surg 1997;64:634-638
© 1997 The Society of Thoracic Surgeons
Hospital Angelina Caron, Campina Grande, Brazil; and the State University of New York at Buffalo and the Buffalo General Hospital, Buffalo, New York
Background. It is reasoned that reducing left ventricular diameter (Laplace's law) in patients with dilated cardiomyopathy, will improve ventricular function.
Methods. Partial left ventriculectomy was performed in 120 patients with end-stage dilated cardiomyopathies of varying causes. Most patients were in New York Heart Association functional class IV. The procedure consisted of removal of a wedge of left ventricular muscle from the apex to the base of the heart. Depending on the distance between the two papillary muscles, the mitral valve apparatus was either preserved, repaired, or replaced with a tissue prosthesis.
Results. The 30-day mortality was 22% and the 2-year survival was 55%. Although 10% of surviving patients showed no improvement in New York Heart Association functional class, most of the surviving patients were in either class I (57%) or II (33.3%), and the others were in class III and IV.
Conclusions. Partial left ventriculectomy can be used to treat end-stage dilated cardiomyopathy. Further studies and a longer follow-up period are needed to fully assess the effects of this procedure.
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Z. Popovic, M. Miric, S. Gradinac, A. N. Neskovic, L. Jovovic, L. Vuk, M. Bojic, and A. D. Popovic Effects of partial left ventriculectomy on left ventricular performance in patients with nonischemic dilated cardiomyopathy J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1801 - 1808. [Abstract] [Full Text] [PDF]
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S. Gradinac, M. Miric, Z. Popovic, A. D. Popovic, A. N. Neskovic, L. Jovovic, L. Vuk, and M. Bojic Partial left ventriculectomy for idiopathic dilated cardiomyopathy: early results and six-month follow-up Ann. Thorac. Surg., December 1, 1998; 66(6): 1963 - 1968. [Abstract] [Full Text] [PDF]
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J. Y. Kresh and A. S. Wechsler Heart reduction surgery can reconstitute the residual stress-strain state of the left ventricle J. Thorac. Cardiovasc. Surg., December 1, 1998; 116(6): 1084 - 1086. [Full Text]
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N. A.G. Stolf, L. F. P. Moreira, E. A. Bocchi, M. de Lourdes Higuchi, F. Bacal, G. Bellotti, and A. D. Jatene Determinants of midterm outcome of partial left ventriculectomy in dilated cardiomyopathy Ann. Thorac. Surg., November 1, 1998; 66(5): 1585 - 1591. [Abstract] [Full Text] [PDF]
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L. F. P. Moreira, N. A. G. Stolf, E. A. Bocchi, F. Bacal, M. C. P. Giorgi, J. R. Parga, and A. D. Jatene Partial left ventriculectomy with mitral valve preservation in the treatment of patients with dilated cardiomyopathy J. Thorac. Cardiovasc. Surg., April 1, 1998; 115(4): 800 - 807. [Abstract] [Full Text] [PDF]
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J. Gorcsan III, A. M. Feldman, R. L. Kormos, W. A. Mandarino, A. J. Demetris, and R. J. V. Batista Heterogeneous Immediate Effects of Partial Left Ventriculectomy on Cardiac Performance Circulation, March 10, 1998; 97(9): 839 - 842. [Abstract] [Full Text] [PDF]
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