Partial left ventriculectomy to treat end-stage heart disease.
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.
Batista
R J
RJ
Hospital Angelina Caron, Campina Grande, Brazil.
Verde
J
J
Nery
P
P
Bocchino
L
L
Takeshita
N
N
Bhayana
J N
JN
Bergsland
J
J
Graham
S
S
Houck
J P
JP
Salerno
T A
TA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001794:Blood Pressure; D002311:Cardiomyopathy, Dilated / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000601:surgery; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D010210:Papillary Muscles / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000209:etiology; D051437:Renal Insufficiency / Q000209:etiology; D015996:Survival Rate; D013536:Suture Techniques; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000601:surgery; D016276:Ventricular Function