PMID- 10440648
OWN - NLM
STAT- MEDLINE
DCOM- 19990916
LR  - 20190921
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 13
IP  - 5
DP  - 1998 Sep-Oct
TI  - Partial left ventriculectomy in patients with dialated failing ventricle.
PG  - 335-42
AB  - BACKGROUND: While partial left ventriculectomy (PLV) improves left ventricular 
      energetic efficiency, concomitant reduction in mitral regurgitation may improve 
      ventricular function. METHODS: Two hundred ninety-five patients undergoing 
      lateral ventricular wall excision between the papillary muscles (lateral PLV) and 
      101 patients with an additional excision of papillary muscles and mitral valve 
      replacement (extended PLV) were compared with 65 patients undergoing excision of 
      anterior wall or ventricular aneurysm (anterior PLV). RESULTS: All patients had 
      reduced functional capacity, New York Heart Association (NYHA) Class III to IV 
      (3.62+/-0.49). Etiologies were cardiomyopathy (37.3%), coronary artery disease 
      (32.3%), valvular disease (19.7%), Chagas' disease (7.8%), and others (2.8%). 
      Patients undergoing lateral and extended PLV had cardiomyopathy as the primary 
      cause of heart failure, while a majority of anterior PLV patients had ischemic 
      disease. Associated procedures included mitral valvuloplasty or replacement 
      (lateral PLV 67%, extended PLV 100%, anterior PLV 40%) and tricuspid annuloplasty 
      (67%, 76%, 28%, respectively.) In each group after surgery, end-systolic 
      dimension decreased more than end-diastolic dimension despite reduced mitral 
      regurgitation. Although extended PLV resulted in greater volume reduction and 
      less mitral regurgitation, these patients had delayed recovery and poor survival. 
      Patients with valvular disease had the most advanced myocardial hypertrophy with 
      the best survival, while those with Chagas' disease had more severe myocarditis, 
      interstitial fibrosis, and the poorest survival. CONCLUSION: Lateral PLV improved 
      hemodynamics and functional capacity as much as aneurysmectomy by reducing 
      ventricular volume and mitral regurgitation. Inclusion and exclusion criteria 
      have to be sought to make PLV safer and more effective.
FAU - Kawaguchi, A T
AU  - Kawaguchi AT
AD  - Cardiovascular Surgery and Transplantation, Tokai University School of Medicine, 
      Isehara, Japan. akira@is.icc.u-tokai.ac.jp
FAU - Bergsland, J
AU  - Bergsland J
FAU - Ishibashi-Ueda, H
AU  - Ishibashi-Ueda H
FAU - Ujiie, T
AU  - Ujiie T
FAU - Shimura, S
AU  - Shimura S
FAU - Koide, S
AU  - Koide S
FAU - Salerno, T A
AU  - Salerno TA
FAU - Batista, R J
AU  - Batista RJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Cardiac Surgical Procedures/*methods
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/etiology/mortality/*surgery
MH  - Heart Ventricles/diagnostic imaging/physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Ventricular Dysfunction/complications/mortality/*surgery
EDAT- 1999/08/10 00:00
MHDA- 1999/08/10 00:01
CRDT- 1999/08/10 00:00
PHST- 1999/08/10 00:00 [pubmed]
PHST- 1999/08/10 00:01 [medline]
PHST- 1999/08/10 00:00 [entrez]
AID - 10.1111/j.1540-8191.1998.tb01094.x [doi]
PST - ppublish
SO  - J Card Surg. 1998 Sep-Oct;13(5):335-42. doi: 10.1111/j.1540-8191.1998.tb01094.x.