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Partial left ventriculectomy in association with dilated cardiomyopathy: echocardiographic follow-up
Susumu Nakamoto1, Hidetaka Oku, Hitoo Fukuhara
1Department of Cardiovascular Surgery, Kinki University, School of Medicine, Osakasayama, Osaka, Japan. snakamot@med.kindai.ac.jp
Insights
This study reports on a patient with dilated cardiomyopathy who underwent left ventriculectomy. The procedure, aimed at improving heart function and removing thrombus, resulted in stable long-term outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
- Regenerative Medicine
Background:
- Idiopathic dilated cardiomyopathy (DCM) can lead to severe left ventricular dysfunction and thrombus formation.
- Surgical interventions like left ventriculectomy are considered for advanced DCM.
- The Batista operation is a surgical technique involving myocardial resection to remodel the left ventricle.
Observation:
- A 19-year-old male patient with DCM and a history of cerebral infarction due to left ventricular thrombus underwent a left ventriculectomy.
- Approximately 12x4cm of myocardial tissue was resected.
- Left ventricular diastolic dimension showed a temporary reduction at 1 month post-surgery, followed by an increase.
Findings:
- The patient survived longer than any other in Japan following this specific operation.
- Over 45 months of follow-up, key cardiac parameters including left ventricular diastolic dimension, cardiac output, and New York Heart Association functional class remained stable and comparable to preoperative values.
- The surgical intervention successfully managed the left ventricular thrombus and did not lead to further deterioration of cardiac function.
Implications:
- This case highlights the potential long-term viability of left ventriculectomy in select DCM patients.
- The findings suggest that Batista's operation can be a safe and effective option for managing complex DCM cases with thrombus.
- Further research into patient selection and long-term outcomes of myocardial resection procedures is warranted.
Abstract:
Left ventricular function after a left ventriculectomy was assessed in a patient with idiopathic dilated cardiomyopathy (DCM) who has survived longer than any other patient in Japan after this operation. The 19-year-old male had a history of cerebral infarction because of left ventricular thrombus associated with DCM. In order to remove the thrombus and improve left ventricular function, an approximately 12x4cm piece of myocardial tissue was resected according to the methods of Batista's operation. Left ventricular diastolic dimension was temporarily reduced 1 month after surgery, but increased again. During the 45 months of follow-up, left ventricular diastolic dimension, cardiac output and New York Heart Association functional class remain unchanged from the preoperative values.