HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Edimar A. Bocchi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Moreira, L. F. P. Articles by Jatene, A. D. Search for Related Content PubMed PubMed Citation Articles by Moreira, L. F. P. Articles by Jatene, A. D.

J Thorac Cardiovasc Surg 1998;115:800-807
© 1998 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

Partial left ventriculectomy with mitral valve preservation in the treatment of patients with dilated cardiomyopathy

Supported by grant 1058/95/58 from Fundação E. J. Zerbini, São Paulo, Brazil.

Received for publication July 10, 1997. Revisions requested Oct. 10, 1997; revisions received Nov. 11, 1997. Accepted for publication Nov. 11, 1997. Address for reprints: Luiz Felipe P. Moreira, MD, Divisão de Cirurgia—Instituto do Coração, Av. Dr. Enéas Carvalho Aguiar, 44, São Paulo, SP, Brazil. CEP:05403-000

Abstract

Objective: This study reports initial results of partial left ventriculectomy performed with preservation of the mitral valve in the treatment of 27 patients with idiopathic dilated cardiomyopathy.
Methods: Patients were in New York Heart Association class III or IV. Partial ventriculectomy was performed as an isolated procedure in four patients and associated with mitral annuloplasty in 23 patients. There were four hospital deaths (14.8%) and the remaining patients were followed for 11.2 ± 6 months.
Results: Decrease of left ventricular diastolic diameter (81.8 ± 8.7 to 68.5 ± 7.6 mm, p < 0.001) and improvement of left ventricular wall shortening (12% ± 3.1% to 18.1% ± 3.9%, p < 0.001) were demonstrated by echocardiography after the operation. Left ventricular radioisotopic angiography showed reduction of diastolic volume (495 ± 124 ml to 352 ± 108 ml, p < 0.001) and increase of ejection fraction (17.7% ± 4.6% to 23.7% ± 8.8%, p < 0.001). Right-sided heart catheterization demonstrated improvement of stroke index (24.3 ± 7.7 ml/m² to 28.3 ± 7.6 ml/m², p < 0.01) and decrease of pulmonary wedge pressure (23.2 ± 8.8 mm Hg to 17 ± 7 mm Hg, p < 0.01). Similar results were documented at 6 and 12 months of follow-up. Functional class improved from 3.6 ± 0.5 to 1.4 ± 0.6 (p < 0.001). However, seven patients died at midterm follow-up because of heart failure progression or arrhythmia-related events, and survival rate was 59.2% ± 9.4% from 6 to 24 months of follow-up.
Conclusions: Partial left ventriculectomy performed with preservation of the mitral valve improves left ventricular function and congestive heart failure in patients with dilated cardiomyopathy. Nevertheless, the high incidences of heart failure progression and arrhythmia-related deaths observed after this procedure preclude its wide clinical application. (J Thorac Cardiovasc Surg 1998;115:800-7)

This article has been cited by other articles:

				T. Koyama, K. Nishimura, Y. Soga, O. Unimonh, and M. Komeda Reply to the Editor J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 2110 - 2111. [Full Text] [PDF]

				K.-l. He, J. Shimizu, G.-h. Yi, A. Gu, M. A. Kashem, D. L. Crabbe, S. Popilskis, E. X. Wu, W. P. Santamore, D. Melvin, et al. Left ventricular systolic performance in failing heart improved acutely by left ventricular reshaping J. Thorac. Cardiovasc. Surg., July 1, 2003; 126(1): 56 - 65. [Abstract] [Full Text] [PDF]

				S. S Kabbani, M. B. Izzat, H. Jamil, B. Akasheh, D. Hanania, and H. Raffa Left Ventricular Volume Reduction Surgery in the Middle East Asian Cardiovasc Thorac Ann, June 1, 2003; 11(2): 99 - 101. [Abstract] [Full Text] [PDF]

				L. F. P. Moreira, A. Benicio, F. Bacal, E. A. Bocchi, N. A.G. Stolf, and S. A. Oliveira Determinants of long-term mortality of current palliative surgical treatment for dilated cardiomyopathy Eur. J. Cardiothorac. Surg., May 1, 2003; 23(5): 756 - 764. [Abstract] [Full Text] [PDF]

				T. Koyama, K. Nishimura, Y. Soga, O. Unimonh, K. Ueyama, and M. Komeda Importance of preserving the apex and plication of the base in left ventricular volume reduction surgery J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 669 - 677. [Abstract] [Full Text] [PDF]

				R. M. Kanashiro, E. Nozawa, N. Murad, L. R. Gerola, V. A. Moises, and P. J.F. Tucci Myocardial infarction scar plication in the rat: cardiac mechanics in an animal model for surgical procedures Ann. Thorac. Surg., May 1, 2002; 73(5): 1507 - 1513. [Abstract] [Full Text] [PDF]

				J. H. Artrip, M. C. Oz, and D. Burkhoff Left ventricular volume reduction surgery for heart failure: A physiologic perspective J. Thorac. Cardiovasc. Surg., October 1, 2001; 122(4): 775 - 782. [Abstract] [Full Text] [PDF]

				M. Unal, C. Konuralp, and E. Kopman Ventricular containment technique in ischemic cardiomyopathy Ann. Thorac. Surg., October 1, 2001; 72(4): 1446 - 1447. [Full Text] [PDF]

				R. Yanagida, M. Sugawara, A. Kawai, and H. Koyanagi Regional differences in myocardial work of the left ventricle in patients with idiopathic dilated cardiomyopathy: Implications for the surgical technique used for left ventriculoplasty J. Thorac. Cardiovasc. Surg., September 1, 2001; 122(3): 600 - 607. [Abstract] [Full Text] [PDF]

				R. U. Nair, S. G. Williams, K. U. Nwafor, A. S. Hall, and L.-B. Tan Left ventricular volume reduction without ventriculectomy Ann. Thorac. Surg., June 1, 2001; 71(6): 2046 - 2049. [Abstract] [Full Text] [PDF]

				T. Isomura, H. Suma, T. Horii, T. Sato, T. Kobashi, H. Kanemitsu, J. Hoshino, and K. Hisatomi Left ventricle restoration in patients with non-ischemic dilated cardiomyopathy: risk factors and predictors of outcome and change of mid-term ventricular function Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 684 - 689. [Abstract] [Full Text] [PDF]

				A. Franco-Cereceda, P. M. McCarthy, E. H. Blackstone, K. J. Hoercher, J. A. White, J. B. Young, and R. C. Starling Partial left ventriculectomy for dilated cardiomyopathy: Is this an alternative to transplantation? J. Thorac. Cardiovasc. Surg., May 1, 2001; 121(5): 879 - 893. [Abstract] [Full Text] [PDF]

				M. Idiz, C. Konuralp, and M. Unal How can we obtain maximal benefits from partial left ventriculectomy? Eur. J. Cardiothorac. Surg., April 1, 2001; 19(4): 537 - 538. [Full Text] [PDF]

				L. F. P. Moreira, N. A.G. Stolf, M. d. L. Higuchi, F. Bacal, E. A. Bocchi, and S. A. Oliveira Current perspectives of partial left ventriculectomy in the treatment of dilated cardiomyopathy Eur. J. Cardiothorac. Surg., January 1, 2001; 19(1): 54 - 60. [Abstract] [Full Text] [PDF]

				M. Ratcliffe Batista's operation: what have we learned? J. Am. Coll. Cardiol., December 1, 2000; 36(7): 2115 - 2118. [Full Text] [PDF]

				K. M. Vural and O. TasdemIr Mid-term results of partial left ventriculectomy in end-stage heart disease Eur. J. Cardiothorac. Surg., November 1, 2000; 18(5): 550 - 556. [Abstract] [Full Text] [PDF]

				H. Suma, T. Isomura, T. Horii, T. Sato, N. Kikuchi, K. Iwahashi, and J. Hosokawa NONTRANSPLANT CARDIAC SURGERY FOR END-STAGE CARDIOMYOPATHY J. Thorac. Cardiovasc. Surg., June 1, 2000; 119(6): 1233 - 1245. [Abstract] [Full Text] [PDF]

				S. Westaby HEART FAILURE: Non-transplant surgery for heart failure Heart, May 1, 2000; 83(5): 603 - 603. [Full Text]

				P. M. Cury, M. d. L. Higuchi, P. S. Gutierrez, L. F. P. Moreira, E. A. Bocchi, N. A.G. Stolf, and A. D. Jatene Autopsy findings in early and late postoperative death after partial left ventriculectomy Ann. Thorac. Surg., March 1, 2000; 69(3): 769 - 773. [Abstract] [Full Text] [PDF]

				T. Isomura, H. Suma, T. Horii, T. Sato, and N. Kikuchi Partial left ventriculectomy, ventriculoplasty or valvular surgery for idiopathic dilated cardiomyopathy - the role of intra-operative echocardiography Eur. J. Cardiothorac. Surg., March 1, 2000; 17(3): 239 - 245. [Abstract] [Full Text] [PDF]

				M. B. Izzat, S. S. Kabbani, H. Suma, K. Pandey, K. Morishita, and A. P.C. Yim Early experience with partial left ventriculectomy in the Asia-Pacific region Ann. Thorac. Surg., June 1, 1999; 67(6): 1703 - 1707. [Abstract] [Full Text] [PDF]

				S. W. Etoch, S. C. Koenig, M. A. Laureano, P. Cerrito, L. A. Gray, and R. D. Dowling RESULTS AFTER PARTIAL LEFT VENTRICULECTOMY VERSUS HEART TRANSPLANTATION FOR IDIOPATHIC CARDIOMYOPATHY J. Thorac. Cardiovasc. Surg., May 1, 1999; 117(5): 952 - 959. [Abstract] [Full Text] [PDF]

				M. B. Ratcliffe, J. Hong, A. Salahieh, S. Ruch, and A. W. Wallace The effect of ventricular volume reduction surgery in the dilated, poorly contractile left ventricle: A simple finite element analysis J. Thorac. Cardiovasc. Surg., October 1, 1998; 116(4): 566 - 577. [Abstract] [Full Text] [PDF]