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Partial left ventriculectomy: sunrise or sunset?

R C Starling1, P M McCarthy

  • 1Department of Cardiology, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, OH 44195, USA. starlir@ccf.org

European Journal of Heart Failure
|August 11, 2000
PubMed
Summary
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Partial left ventriculectomy (PLV) showed a 37% event-free survival at two years for advanced heart failure patients. This surgical option did not match cardiac transplantation outcomes and requires further study.

Area of Science:

  • Cardiovascular Surgery
  • Heart Failure Management
  • Transplantation Alternatives

Background:

  • Advanced heart failure presents limited treatment options.
  • Cardiac transplantation is the gold standard but faces donor organ scarcity.
  • Partial left ventriculectomy (PLV) emerged as a potential surgical alternative.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of Partial Left Ventriculectomy (PLV) as an alternative to cardiac transplantation.
  • To assess the survival and event-free survival rates following PLV in patients with advanced heart failure.

Main Methods:

  • A cohort of 62 patients with advanced heart failure underwent PLV between May 1996 and December 1998.
  • Patients were candidates for cardiac transplantation.

Related Experiment Videos

  • Outcomes including mortality, need for left ventricular assist device (LVAD), and functional class were tracked.

    • Main Results:

    • Perioperative mortality was 3.2%.
    • 16% of patients required LVAD implantation due to post-operative shock.
    • Two-year survival was 68%, with event-free survival at 37%.
    • Event-free survivors showed improved NYHA class and oxygen consumption.

    Conclusions:

    • Partial left ventriculectomy (PLV) demonstrates a significant early failure rate.
    • Current PLV outcomes are not equivalent to cardiac transplantation.
    • Further investigation is needed to define the role of PLV in advanced heart failure treatment.