Improved left ventricular contraction and energetics in a patient with Chagas' disease undergoing partial left ventriculectomy.
A 43-year-old patient with heart failure, precluded from heart transplantation or dynamic cardiomyoplasty because of Chagas' disease cardiomyopathy, mitral regurgitation, and ventricular mural thrombi, underwent mitral valvuloplasty and partial left ventriculectomy (PLV) between the papillary muscles. Intraoperative pressure-volume relationship analyses suggested improvement in left ventricular contraction, energetics, isovolumic relaxation, and mitral valve competency. These improvements allowed prompt, short-term recovery despite unchanged myocardial pathology, which suggests that a surgical approach can alter anatomic-geometric factors and achieve clinical improvement in a dilated failing ventricle.
Kawaguchi
A T
AT
Tokai University School of Medicine, Isehara, Japan. akira@is.icc.u-tokai.ac.jp
Sugimachi
M
M
Sunagawa
K
K
Bergsland
J
J
Koide
S
S
Batista
R J
RJ
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D002598:Chagas Cardiomyopathy / Q000503:physiopathology / Q000601:surgery*; D004734:Energy Metabolism; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000601:surgery; D010210:Papillary Muscles / Q000601:surgery; D016896:Treatment Outcome; D016277:Ventricular Function, Left