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Ann Thorac Surg 1999;67:1541-1542
© 1999 The Society of Thoracic Surgeons

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Correspondence

Why does partial left ventriculectomy work on dilated cardiomyopathy?

^a Thoracic Surgical Oncology, Roswell Park Cancer Institute, Elm and Carlton St, Buffalo, NY, USA 14263

e-mail: YCUI{at}sc3103.med.buffalo.edu

To the Editor

Although Stolf and colleagues considered that patient selection with mean myocyte diameters less than 22 µm could improve the outcome [1], it is still unknown what the exact role of partial left ventriculectomy (PLV) is. Research into the effect of PLV seems always focused on the left ventricular (LV) free wall, and rarely is focused on whether the interventricular septum or right ventricle (RV) is involved. Actually, the interventricular septum plays a role in the biventricular function [2]; even septal position could affect heart function [3]. Does PLV improve the function of interventricular septum?

It seems a reasonable speculation that PLV may not only decrease LV free wall tension [4], but also decrease interventricular septal tension, according to Laplace’s law, and eventually improve septal function. On the other hand, adequate resection of LV muscle could make the interventricular septum shift rightward, and this septal position convex to RV might bring benefit to biventricular function; particularly, when RV function is relatively preferable to LV function, LV function might in part be compensated by the RV contraction through the interventricular septal movement leftward.

It might be advisable for those authors to demonstrate more data about septum and RV to analyze if interventricular septum could play a role in PLV.

References

1. Stolf N.A.G., Moreira L.F.P., Bocchi E.A., et al. Determinants of midterm outcome of partial left ventriculectomy in dilated cardiomyopathy. Ann Thorac Surg 1998;66:1585-1591.[Abstract/Free Full Text]
2. Li K.S., Santamore W.P. Contribution of each wall to biventricular function. Cardiovasc Res 1993;27:792-800.[Abstract/Free Full Text]
3. Hendry P.J., Ascah K.J., Rajagopalan K., Calvin J.E. Does septal position affect right ventricular function during left ventricular assist in an experiment porcine model?. Circulation 1994;90(suppl 2):353-358.
4. Batista R.J.V., Verde J., Nery P., et al. Partial left ventriculectomy to treat end-stage heart disease. Ann Thorac Surg 1997;64:634-638.[Abstract/Free Full Text]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cui, Y. Search for Related Content PubMed Articles by Cui, Y. Related Collections Related Article