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Partial left ventriculectomy: overall and late results in 44 class IV patients with 4-year follow-up

F A Lucchese1, J D Frota Filho, C Blacher

  • 1São Francisco Hospital at Complexo Hospitalar da Santa Casa, Porto Alegre, RS, Brazil.

Journal of Cardiac Surgery
|June 21, 2001
PubMed

Insights

Partial left ventriculectomy (PLV) improved cardiac function in dilated cardiomyopathy patients but had high mortality. PLV may serve as a bridge to heart transplantation for select patients.

Area of Science:

  • Cardiovascular Surgery
  • Cardiology
  • Heart Failure Management

Background:

  • Dilated cardiomyopathy (DCM) presents significant challenges in heart failure management.
  • Partial left ventriculectomy (PLV) is a surgical option explored for advanced DCM.

Purpose of the Study:

  • To report long-term outcomes of partial left ventriculectomy (PLV) in patients with dilated cardiomyopathy.
  • To evaluate the impact of PLV on ventricular function, quality of life, and survival rates.

Main Methods:

  • A cohort of 44 patients with dilated cardiomyopathy underwent PLV over a 4-year period.
  • Comprehensive assessments included echocardiograms, cardiac catheterization, and maximal oxygen consumption (VO2) stress tests.

Main Results:

  • Survivors showed improved ejection fraction (22.1% to 30.9%), reduced LV end-diastolic diameter (79.4 mm to 61.9 mm), and enhanced VO2 (8.8 to 15.8 mL/kg/min).
  • Significant improvements were also noted in non-survivors prior to death.
  • Survival rates at 3, 6, 12, and 18 months were 56.8%, 47.7%, 38.4%, and 35.9%, respectively, stabilizing around 32.7% long-term.
  • Arrhythmias and heart failure were primary causes of mortality.

Conclusions:

  • While PLV improves ventricular function and quality of life for survivors, high mortality remains a significant concern.
  • PLV can be a viable option for patients awaiting heart transplantation, particularly those with high pulmonary vascular resistance (PVR) or when other options are unavailable.
Abstract

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