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Related Experiment Videos

Left ventricular volume reduction without ventriculectomy.

R U Nair1, S G Williams, K U Nwafor

  • 1Institute for Cardiac Surgery and Cardiovascular Research, Leeds General Infirmary, United Kingdom. unair@ulth.northy.nhs.uk

The Annals of Thoracic Surgery
|June 28, 2001
PubMed
Summary
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A new surgical technique for left ventricular volume reduction (LVVR) realigns papillary muscles, avoiding ventriculectomy. This procedure significantly improved heart function and exercise capacity in patients with end-stage heart failure.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Resynchronization Therapy
  • Heart Failure Management

Background:

  • End-stage dilated cardiomyopathy often necessitates cardiac transplantation.
  • Partial left ventriculectomy (Batista procedure) is an alternative for left ventricular volume reduction (LVVR).
  • A novel LVVR technique avoiding ventriculectomy is presented.

Purpose of the Study:

  • To describe and evaluate a new LVVR technique using papillary muscle realignment.
  • To assess the preliminary efficacy of this novel LVVR approach.

Main Methods:

  • Eight male patients underwent LVVR with papillary muscle realignment adjunct to coronary revascularization.
  • Echocardiography and cardiopulmonary exercise testing were used for pre- and post-operative assessment in five patients.

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  • Mean follow-up was 267 days.

    • Main Results:

    • Significant improvement in left ventricular end-diastolic volume (254 to 218 mL, p=0.03).
    • Significant improvement in left ventricular ejection fraction (20.14% to 31.28%, p=0.007).
    • Significant improvement in exercise duration (394 to 611 seconds, p=0.03).

    Conclusions:

    • LVVR via papillary muscle realignment is a relatively simple technique performed via small apical cardiotomy.
    • Preliminary results indicate encouraging functional improvement post-surgery.
    • Further controlled studies are needed to validate this novel LVVR technique.