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Ann Thorac Surg 2000;69:1841
© 2000 The Society of Thoracic Surgeons

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Invited commentary

Invited commentary

^a Heart Institute University of São Paulo, Av Dr Eneas de Carvalho Aguiar 44, Cerqueira Cesar - São Paulo 05403-000, Brazil

e-mail: stolf{at}incor.usp.br

Partial left ventriculectomy (PLV) has raised great interest due to the limitations of heart transplantation such as the shortage of donors, the additional psychosocial contraindications, as well as side effects of present immunosuppressive therapy. PLV has virtually no contraindication and is low cost. Our experiences have shown high early mortality and low midterm survival, limiting its wide indication.

The authors focus on an extremely important aspect that being the study of factors influencing outcomes. In this regard we have previously shown that myocyte was the unique determinant of survival during the first six months of evolution. The present study confirms this observation but they have shown that fibrosis was also a risk factor.

I believe that the preoperative identification of patients with predominant anatomical remodeling instead of patients with severe intrinsic myocardial damage could improve PLV outcomes and contribute to this procedure as a real alternative in the spectrum of the surgical treatment of cardiac failure. However, further studies are necessary to clarify the exact role of the myocardial influence.

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Partial left ventriculectomy: which patients can be expected to benefit?

O.H. Frazier, Sinisa Gradinac, Ana M. Segura, Piotr Przybylowski, Zoran Popovic, Jovan Vasiljevic, Antonietta Hernandez, Hugh A. McAllister, Jr, Milovan Bojic, and Branislav Radovancevic
Ann. Thorac. Surg. 2000 69: 1836-1841. [Abstract] [Full Text] [PDF]

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 Google Scholar Google Scholar Articles by Stolf, N. A.G. Search for Related Content PubMed Articles by Stolf, N. A.G. Related Collections Related Article