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Related Experiment Videos

Left ventricular reduction surgery with mitral valve repair.

P M McCarthy1, R C Starling, J B Young

  • 1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio 44195, USA. mccartp@cesmtp.ccf.org

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|October 4, 2000
PubMed
Summary

Mitral valve repair combined with partial left ventriculectomy improved heart function and quality of life in patients with severe heart failure. This surgical approach demonstrated early survival benefits and functional gains in transplant candidates.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Heart Failure Management

Background:

  • Idiopathic dilated cardiomyopathy significantly impairs cardiac function, often leading to end-stage heart failure.
  • Patients with end-stage heart failure frequently require advanced therapies like heart transplantation or mechanical support.
  • The Batista procedure, combining mitral valve repair with partial left ventriculectomy, is an investigational surgical option for select heart failure patients.

Purpose of the Study:

  • To investigate the echocardiographic changes and functional outcomes following mitral valve repair and partial left ventriculectomy (PLV).
  • To evaluate the early efficacy and safety of the Batista procedure in patients with idiopathic dilated cardiomyopathy.

Main Methods:

  • A cohort of 57 patients, primarily heart transplant candidates with idiopathic dilated cardiomyopathy, underwent mitral valve repair and PLV.

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  • Pre-operative and post-operative echocardiographic parameters, New York Heart Association (NYHA) functional class, and peak oxygen consumption were assessed.
  • In-hospital mortality, actuarial survival, and freedom from adverse events were monitored.

    • Main Results:

    • The procedure resulted in significant improvements in left ventricular dimensions and ejection fraction at 3 months.
    • Patients experienced a marked improvement in NYHA functional class and peak oxygen consumption.
    • Early outcomes included a 3.5% in-hospital mortality rate, 82.1% 1-year survival, and 58% freedom from death, re-listing for transplant, or LVAD support.

    Conclusions:

    • Mitral valve repair with PLV (Batista procedure) shows promising early results for selected patients with end-stage dilated cardiomyopathy.
    • The procedure can lead to significant functional class improvement and enhanced exercise capacity.
    • Further investigation is warranted to fully understand the long-term implications and optimize the application of this surgical technique.