Partial left ventriculectomy in patients with dilated failing ventricle

Akira T. Kawaguchi, Jacob Bergsland, Hatsue Ishibashi-Ueda, Toshimi Ujiie, Shinichiro Shimura, Shirosaku Koide, Tomas Salerno, Randas J V Batista

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)335-342
Number of pages8
JournalJournal of Cardiac Surgery
Volume13
Issue number5
StatePublished - Dec 1 1998
Externally publishedYes

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Mitral Valve Insufficiency
Chagas Disease
Papillary Muscles
Cardiomyopathies
Survival
Ventricular Function
Myocarditis
Mitral Valve
Hypertrophy
Aneurysm
Coronary Artery Disease
Fibrosis
Heart Failure
Hemodynamics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kawaguchi, A. T., Bergsland, J., Ishibashi-Ueda, H., Ujiie, T., Shimura, S., Koide, S., ... Batista, R. J. V. (1998). Partial left ventriculectomy in patients with dilated failing ventricle. Journal of Cardiac Surgery, 13(5), 335-342.

Partial left ventriculectomy in patients with dilated failing ventricle. / Kawaguchi, Akira T.; Bergsland, Jacob; Ishibashi-Ueda, Hatsue; Ujiie, Toshimi; Shimura, Shinichiro; Koide, Shirosaku; Salerno, Tomas; Batista, Randas J V.

In: Journal of Cardiac Surgery, Vol. 13, No. 5, 01.12.1998, p. 335-342.

Research output: Contribution to journalArticle

Kawaguchi, AT, Bergsland, J, Ishibashi-Ueda, H, Ujiie, T, Shimura, S, Koide, S, Salerno, T & Batista, RJV 1998, 'Partial left ventriculectomy in patients with dilated failing ventricle', Journal of Cardiac Surgery, vol. 13, no. 5, pp. 335-342.
Kawaguchi AT, Bergsland J, Ishibashi-Ueda H, Ujiie T, Shimura S, Koide S et al. Partial left ventriculectomy in patients with dilated failing ventricle. Journal of Cardiac Surgery. 1998 Dec 1;13(5):335-342.
Kawaguchi, Akira T. ; Bergsland, Jacob ; Ishibashi-Ueda, Hatsue ; Ujiie, Toshimi ; Shimura, Shinichiro ; Koide, Shirosaku ; Salerno, Tomas ; Batista, Randas J V. / Partial left ventriculectomy in patients with dilated failing ventricle. In: Journal of Cardiac Surgery. 1998 ; Vol. 13, No. 5. pp. 335-342.
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