PMID- 11713852
OWN - NLM
STAT- MEDLINE
DCOM- 20020215
LR  - 20190921
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 16
IP  - 1
DP  - 2001 Jan-Feb
TI  - Partial left ventriculectomy: the 2nd International Registry Report 2000.
PG  - 10-23
AB  - BACKGROUND: Partial left ventriculectomy (PLV) has been performed without 
      standardized inclusion or exclusion criteria. METHODS: An international registry 
      of PLV was expanded, updated, and refined to include 287 nonischemic cases 
      voluntarily reported from 48 hospitals in 11 countries. RESULTS: Gender, age, 
      ventricular dimension, etiology, ethnology, myocardial mass, operative variation, 
      presence or absence of mitral regurgitation, and transplant indication had no 
      effects on event-free survival, which was defined as absence of death or 
      ventricular failure that required a ventricular assist device or listing for 
      transplantation. Preoperative patient conditions, such as duration of symptoms (> 
      9 vs < 3 years; p = 0.001), New York Heart Association (NYHA) class (Class IV vs 
      < Class IV; p = 0.002), depressed contractility (fractional shortening [FS] < 5% 
      vs > 12%; p = 0.001), and refractory decompensation that required emergency 
      procedure (p < 0.001) were associated with reduced event-free survival. Five or 
      more cases in each hospital led to significantly better outcomes than the initial 
      four cases. Rescue procedures for 14 patients nonsignificantly improved patient 
      survival (2-year survival 52%) over event-free survival (2-year survival 48%; p = 
      0.49), with improved NYHA class among survivors (3.6 to 1.8; p < 0.001). Outcome 
      was better in 1999 than in all series before 1999 (p = 0.02) most likely due to 
      patient selection, which was refined to avoid known risk factors such as reduced 
      proportion of patients in NYHA Class IV, FS < 5%, and hospitals with experience 
      in 10 or less cases. A combination of these risk factors could have stratified 17 
      high-risk patients with 0% 1-year survival and 26 low-risk patients with 75% 
      2-year event-free survival. CONCLUSION: Avoidance of risk factors appears to 
      improve survival and might help stratify high- or low-risk patients. Although 
      less symptomatic patients with preserved contractility had better results after 
      PLV, change of indication requires prospective randomized comparison with medical 
      therapies or other approaches.
FAU - Kawaguchi, A T
AU  - Kawaguchi AT
AD  - Tokai University School of Medicine, Ishara, Kanagawa, Japan. 
      akira@is.icc.u-tokai.ac.jp
FAU - Suma, H
AU  - Suma H
FAU - Konertz, W
AU  - Konertz W
FAU - Popovic, Z
AU  - Popovic Z
FAU - Dowling, R D
AU  - Dowling RD
FAU - Kitamura, S
AU  - Kitamura S
FAU - Bergsland, J
AU  - Bergsland J
FAU - Linde, L M
AU  - Linde LM
FAU - Koide, S
AU  - Koide S
FAU - Batista, R J
AU  - Batista RJ
LA  - eng
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  - Adolescent
MH  - Adult
MH  - Age Distribution
MH  - Aged
MH  - Cardiac Surgical Procedures/methods/mortality
MH  - Cardiomyopathy, Dilated/surgery
MH  - Child
MH  - Child, Preschool
MH  - Disease-Free Survival
MH  - Female
MH  - Heart Failure/surgery
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Infant
MH  - *International Cooperation
MH  - Male
MH  - Middle Aged
MH  - Patient Selection
MH  - Registries/*statistics & numerical data
MH  - Risk Factors
MH  - Time Factors
EDAT- 2001/11/21 10:00
MHDA- 2002/02/16 10:01
CRDT- 2001/11/21 10:00
PHST- 2001/11/21 10:00 [pubmed]
PHST- 2002/02/16 10:01 [medline]
PHST- 2001/11/21 10:00 [entrez]
AID - 10.1111/j.1540-8191.2001.tb00478.x [doi]
PST - ppublish
SO  - J Card Surg. 2001 Jan-Feb;16(1):10-23. doi: 10.1111/j.1540-8191.2001.tb00478.x.