Partial left ventriculectomy for end-stage cardiomyopathy: report of a case.
Cardiac transplantation is an established treatment for end-stage heart failure, but its use is very limited. Partial left ventriculectomy has been reported as an alternative treatment for end-stage dilated cardiomyopathy. However, it has been well recognized that emergency partial left ventriculectomy for intractable decompensation is associated with poor survival. We report a case of a 68-year-old man with a left ventricular end-diastolic diameter of 108 mm, who underwent emergency extended partial left ventriculectomy, without papillary muscle resection, and mitral valve replacement with chordae preservation to deal with ongoing cardiogenic shock caused by end-stage dilated cardiomyopathy. The patient's cardiac status and general condition improved after the operation, and he survived the crisis. This operation should be considered as an alternative strategy for patients with septal motion and very large left ventricle. Thus, we report a successful extended partial left ventriculectomy and mitral valve replacement for end-stage dilated cardiomyopathy with very large left ventricular end-diastolic diameter.
Matsukuma
Seiji
S
Department of Cardiovascular Surgery, Nagasaki University School of Medicine, Nagasaki City, Nagasaki, Japan.
Eishi
Kiyoyuki
K
Hayashi
Tomayoshi
T
Yamachika
Shiro
S
Hazama
Shiro
S
Ariyoshi
Tsuneo
T
Takai
Hideaki
H
Odate
Tomohiro
T
Onohara
Daisuke
D
Yanatori
Makoto
M
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000401:mortality; D004452:Echocardiography; D004630:Emergencies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D009200:Myocardial Contraction; D010101:Oxygen Consumption; D010166:Palliative Care / Q000379:methods*; D010210:Papillary Muscles / Q000601:surgery; D018579:Patient Selection; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000209:etiology; D013318:Stroke Volume; D015996:Survival Rate; D016896:Treatment Outcome