HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Edimar Alcides Bocchi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bocchi, E. A. Articles by Ramires, J. F. Search for Related Content PubMed PubMed Citation Articles by Bocchi, E. A. Articles by Ramires, J. F.

Eur J Cardiothorac Surg 2000;18:458-465
© 2000 Elsevier Science NL

Left ventricular regional wall motion, ejection fraction, and geometry after partial left ventriculectomy. Influence of associated mitral valve repair

Heart Institute-Incor, University of São Paulo Medical School, São Paulo, Brazil

Received 2 February 2000; received in revised form 19 May 2000; accepted 23 May 2000.

Corresponding author. Rua Oscar Freire 2077 apto 161, São Paulo, CEP 06509-011, Brazil. Tel.: +55-11-3064-6446; fax +55-11-3069-5502
e-mail: dcledimar{at}incor.usp.br

Objective: Left partial ventriculectomy has been proposed for treatment of heart failure. We investigated the effects of isolated left partial ventriculectomy and left partial ventriculectomy associated with mitral annuloplasty on refractory heart failure due to idiopathic dilated cardiomyopathy. Methods: Nineteen patients underwent partial left partial ventriculectomy associated with mitral annuloplasty and six patients isolated left partial ventriculectomy. In two patients the left partial ventriculectomy associated with mitral annuloplasty was combined with tricuspid annuloplasty. We evaluated before and after the surgery (24±14 days): the functional class, left ventricular ejection fraction (LVEF), right ventricular ejection fraction (EF), regional wall motion, hemodynamics, mitral regurgitation, left ventricular geometry and coronary angiography. Results: For the overall group LVEF improved from 14.5±8.0 to 30.3±12.2% (P<0.0002) and right ventricular EF from 21.2±7.1 to 28.4±8.3% (P<0.002). In patients who underwent left partial ventriculectomy associated with mitral annuloplasty LVEF increased from 14.5±8.6 to 29.5±12.2% (P<0.002). Isolated left partial ventriculectomy increased LVEF from 13.5±7.5 to 31.5±11.1% (P<0.04). Distal segments of marginal branches of the circumflex artery were not visualized by coronary angiography. Left partial ventriculectomy associated with mitral annuloplasty reduced the wedge pressure from 25.0±12.1 to 18.0±7.0 mmHg (P<0.03) and increased cardiac output from 3.8±0.8 to 4.6±1.1 l/min (P<0.004), while isolated left partial ventriculectomy increased cardiac output from 3.7±1.0 to 4.8±1.3 l/min (P<0.03). Regional wall motion increment was more evident in anterolateral region from 4.2±6.8 to 14±8.3% (P<0.002) except in two patients. Left ventricular geometry changed in most patients, but a homogeneous pattern was not identified. Seven patients died during a mean follow-up of 546±276 days. Survivors had improvement in functional class. Augmentation of LVEF >5% was associated with a favorable clinical outcome with improvement in clinical status without death. Conclusions: Effects of left partial ventriculectomy are not necessarily dependent upon reduction of mitral regurgitation or changes in left ventricular geometry. However, risk of death after the surgery must be reduced for a clinical application.

Key Words: Congestive heart failure • Surgery • Cardiomyopathy • Transplantation • Remodeling • Partial left ventriculectomy • Batista’s procedure

This article has been cited by other articles:

				M. Schafers, J. Stypmann, M. J. Wilhelm, L. Stegger, P. Kies, S. Hermann, C. Schmidt, G. Breithardt, H. H. Scheld, and O. Schober Functional Changes After Partial Left Ventriculectomy and Mitral Valve Repair Assessed by Gated Perfusion SPECT J. Nucl. Med., October 1, 2004; 45(10): 1605 - 1610. [Abstract] [Full Text] [PDF]

				L. F. P. Moreira, A. Benicio, F. Bacal, E. A. Bocchi, N. A.G. Stolf, and S. A. Oliveira Determinants of long-term mortality of current palliative surgical treatment for dilated cardiomyopathy Eur. J. Cardiothorac. Surg., May 1, 2003; 23(5): 756 - 764. [Abstract] [Full Text] [PDF]