title: Early experience with left ventricular volume reduction surgery in Syria.
abstract: OBJECTIVE
  To review our early experience with left ventricular volume reduction surgery (the Batista operation) in the management of patients with end-stage heart failure.
  
  
  METHODS
  Between December 1996 and April 1998, 10 patients (9 males, mean age 32yr) with advanced symptomatic cardiomyopathy underwent left ventricular volume reduction surgery at Damascus University Cardiovascular Surgical Center. The cause of cardiomyopathy was idiopathic in three patients, valvular in four, ischemic in two, and viral myocarditis in one patient. Concomitant procedures included aortic valve replacement in four patients, mitral valve repair in six patients, and coronary artery bypass grafting in two patients.
  
  
  RESULTS
  All patients survived the procedure. Echocardiography prior to discharge documented significant improvement in ejection fraction in all but two patients. Mean follow-up was 7.6 months. After discharge, three patients developed progressive congestive heart failure to which they subsequently succumbed, and two more patients died suddenly late postoperatively. Only two patients continue to show both clinical and echocardiographic evidence of improvement.
  
  
  CONCLUSIONS
  Left ventricular volume reduction surgery cannot be freely advocated until better means are found to identify patients who will benefit from the procedure, and proper prophylaxis against fatal postoperative complications can be afforded.
authors.affiliation: Damascus University Cardiovascular Surgical Center, P.O. Box 2837, Damascus, Syria.
authors.forename: S S
authors.initials: SS
authors.lastname: Kabbani
authors.forename: M B
authors.initials: MB
authors.lastname: Izzat
authors.forename: H
authors.initials: H
authors.lastname: Jamil
authors.forename: A
authors.initials: A
authors.lastname: Hammoud
authors.forename: F
authors.initials: F
authors.lastname: Nabhani
authors.forename: L S
authors.initials: LS
authors.lastname: Kabbani
mesh_terms: D000293:Adolescent; D000328:Adult; D002306:Cardiac Volume / Q000502:physiology; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013593:Syria; D017211:Treatment Failure