Partial left ventriculectomy--The Third International Registry Report 2002.
BACKGROUND
An international registry of partial left ventriculectomy (PLV) has been expanded, updated, and refined to include 440 cases voluntarily reported from 51 hospitals in 11 countries.


RESULTS
Gender, age, ventricular dimension, etiology, ethnology, myocardial mass, operative variation or presence or absence of mitral regurgitation as well as transplant indication had no effects on event-free survival, which was defined as either absence of death or ventricular failure requiring ventricular assist device or listing for transplantation. Preoperative patient condition such as NYHA functional class IV, depressed contractility, and decompensation requiring an emergency procedure were associated with reduced event-free survival. Other risk factors included early date of surgery, lack of experience, and extended myocardial resection. Performance of PLV reached a peak by 1998 and was largely abandoned by 2000 except in Asia, where experienced institutes continue to perform PLV in patients in better condition with preserved myocardial contractility.


CONCLUSIONS
Avoidance of delineated risk factors appears to improve recent survival and may help stratify high- or low-risk patients for PLV. An integrated approach with mechanical and biological circulatory assist may improve prognosis for patients with dilated failing hearts. While frequency of PLV has decreased, the concept of ventricular volume reduction has been extended to other volume reduction procedures and less invasive procedures now under clinical trial.
Kawaguchi
Akira T
AT
Society for Cardiac Volume Reduction, Cardiovascular Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Japan. akira@is.icc.u-tokai.ac.jp
Isomura
Tadashi
T
Konertz
Wolfgang
W
Gradinac
Sinisa
S
Dowling
Robert D
RD
Kitamura
Soichiro
S
Bergsland
Jacob
J
Linde
Leonard M
LM
Koide
Shirosaku
S
Batista
Randas J V
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data*; D002311:Cardiomyopathy, Dilated / Q000145:classification / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D014943:Global Health; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D007223:Infant; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D017063:Outcome Assessment, Health Care; D012042:Registries; D012307:Risk Factors; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000601:surgery*