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Left ventricular volume reduction surgery in the middle East.
Sami S Kabbani1, Mohammad Bashar Izzat, Hisham Jamil
1Damascus University Cardiovascular Surgical Center, Damascus University, PO Box 2837, Damascus, Syria. dam-uncv@net.sy
Asian Cardiovascular & Thoracic Annals
|July 25, 2003
Summary
Left ventricular volume reduction surgery was explored for end-stage heart failure patients in the Middle East due to limited transplant options. The procedure showed a 65.2% survival rate at 18 months, but outcomes require improvement.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Technology
Background:
- Heart transplantation is not widely accepted in the Middle East.
- Left ventricular assist devices are not readily available in the region.
- End-stage heart failure necessitates alternative surgical interventions.
Purpose of the Study:
- To evaluate the feasibility and outcomes of left ventricular volume reduction surgery.
- To assess the efficacy of this procedure in a Middle Eastern population with end-stage heart failure.
- To identify potential improvements for this surgical option in developing regions.
Main Methods:
- A cohort of 41 patients with end-stage heart failure underwent left ventricular volume reduction surgery.
- The study was conducted across four tertiary referral centers in the Middle East from 1996 to 2001.
- Associated cardiac procedures included valve surgeries and coronary artery bypass grafting.
Main Results:
- Hospital mortality was 31.7%.
- The 18-month survival rate for hospital survivors was 65.2%.
- Three patients experienced no benefit from the surgery.
Conclusions:
- Left ventricular volume reduction surgery is a viable, albeit challenging, option for end-stage heart failure in regions with limited advanced cardiac support.
- Patient selection and surgical techniques need refinement to improve outcomes.
- Further research into novel volume reduction methods that preserve viable myocardium is warranted.