PMID- 11200650
OWN - NLM
STAT- MEDLINE
DCOM- 20010315
LR  - 20141120
IS  - 0914-5087 (Print)
IS  - 0914-5087 (Linking)
VI  - 37
IP  - 1
DP  - 2001 Jan
TI  - [Left ventriculoplasty for non-ischemic cardiomyopathy with severe heart failure 
      in 70 patients].
PG  - 1-10
AB  - OBJECTIVES: Treatment of cardiac failure due to non-ischemic cardiomyopathy by 
      left ventriculoplasty using partial left ventriculectomy (Batista operation) or 
      septal anterior ventricular exclusion was evaluated. METHODS: Left 
      ventriculoplasty was performed in 70 patients (59 men and 11 women with a mean 
      age of 51 years) from December 1996 to June 2000. Preoperative New York Heart 
      Association (NYHA) functional class was IV in 43 patients including 29 receiving 
      inotropic support, and class III in 27 patients. Nineteen patients required 
      emergency surgery because of on-going shock and 51 patients were operated 
      electively. Combined cardiac procedures were mitral valve reconstruction in 62 
      patients (45 replacements, 17 repairs), tricuspid annuloplasty in 37, and aortic 
      valve replacement in 4. The initial 24 patients underwent typical Batista 
      operation regardless of myocardial viability. The other 46 patients underwent 
      selective ventriculoplasty to excise or exclude the weakest part according to the 
      findings of the intraoperative echo-guided volume reduction test. RESULTS: The 
      intraaortic balloon pump was used in 12 patients and the left ventricular assist 
      device in 2 patients. Three (5.9%) of the 51 patients who underwent elective 
      operation and 12 (63.2%) of the 19 patients with emergency operation died in the 
      hospital, giving an overall hospital mortality of 21.4% (15/70). Hospital 
      mortality was reduced from 33.3% (8/24) in the initial 24 patients to 15.2% 
      (7/46) in the recent 46 patients with the volume reduction test. Mean ejection 
      fraction increased from 22.2 +/- 6.7% to 29.6 +/- 6.0%. Diastolic dimension 
      decreased from 81.1 +/- 9.5 to 69.8 +/- 19.2 mm. End-diastolic and systolic 
      volume indices decreased from 199.0 +/- 47.9 to 124.1 +/- 34.9 ml/m2 and from 
      154.0 +/- 41.2 to 89.3 +/- 31.7 ml/m2, respectively, at one postoperative month 
      in the 55 hospital survivors. The mean pulmonary capillary wedge pressure 
      decreased from 25.6 +/- 7.8 to 13.6 +/- 4.5 mmHg. Serum brain natriuretic peptide 
      decreased from 999 +/- 647 preoperatively to 547 +/- 362 pg/ml one month after 
      the operation. Thirteen patients (18.6%) died in the late period mainly due to 
      heart failure. Among the 42 survivors, 37 patients returned to NYHA functional 
      class I-II, and cardiac events were rare after one postoperative year. Actuarial 
      survivals at 3 years in elective and emergency operations were 71.9% and 33.3%, 
      respectively. CONCLUSIONS: Left ventriculoplasty is acceptably safe for elective 
      operation and clinical improvement can be obtained by proper surgical procedures 
      and careful postoperative medical treatment.
FAU - Suma, H
AU  - Suma H
AD  - Department of Cardiovascular Surgery, Hayama Heart Center, Shimoyamaguchi 1898, 
      Hayama, Miura-gun, Kanagawa 240-0116.
FAU - Isomura, T
AU  - Isomura T
FAU - Horii, T
AU  - Horii T
FAU - Hisatomi, K
AU  - Hisatomi K
FAU - Sato, T
AU  - Sato T
FAU - Kobashi, T
AU  - Kobashi T
FAU - Kanemitsu, H
AU  - Kanemitsu H
FAU - Hoshino, J
AU  - Hoshino J
FAU - Ueno, H
AU  - Ueno H
FAU - Oda, T
AU  - Oda T
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cardiac Surgical Procedures/methods
MH  - Cardiomyopathy, Dilated/mortality/*surgery
MH  - Elective Surgical Procedures
MH  - Female
MH  - Heart Failure/*complications
MH  - Heart Valve Diseases/complications
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Survival Rate
EDAT- 2001/02/24 12:00
MHDA- 2001/03/17 10:01
CRDT- 2001/02/24 12:00
PHST- 2001/02/24 12:00 [pubmed]
PHST- 2001/03/17 10:01 [medline]
PHST- 2001/02/24 12:00 [entrez]
PST - ppublish
SO  - J Cardiol. 2001 Jan;37(1):1-10.