[Anesthetic management of left ventricular reduction surgery (Batista procedure)]

We experienced anesthetic management of left ventricular reduction surgery (Batista procedure) which is a newly developed procedure for treating end-stage dilated cardiomyopathy. The patient was a 41-year-old man who had been suffering from cardiac failure and refractory ventricular tachycardia. The anesthesia was induced and maintained with meticulous administration of fentanyl. After resection of the left ventricular free-wall, the left ventricular diastolic diameter decreased to 46 mm, from 79 mm of preoperative measurement. Weaning from cardiopulmonary bypass was successful with the use of catecholamines and intra-aortic balloon pumping. Administration of both vasodilators and phosphodiesterase inhibitors such as milrinone also contributed to reducing afterload and maintaining cardiac output. In addition to standard hemodynamic monitoring, transesophageal echocardiography provided invaluable information on determining cardiac dimensions and evaluating left ventricular wall motion.