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Partial left ventriculectomy--The Third International Registry Report 2002.

Akira T Kawaguchi¹, Tadashi Isomura, Wolfgang Konertz

¹Society for Cardiac Volume Reduction, Cardiovascular Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Japan. akira@is.icc.u-tokai.ac.jp

Journal of Cardiac Surgery

|August 22, 2003

Summary

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Partial left ventriculectomy (PLV) outcomes improved by avoiding risk factors like emergency procedures and inexperienced surgeons. This surgical approach, largely abandoned, is now used in Asia for select patients.

Area of Science:

Cardiovascular Surgery
Cardiac Surgery Outcomes
Ventricular Reconstruction

Background:

An international registry of 440 partial left ventriculectomy (PLV) cases from 51 hospitals in 11 countries was analyzed.
PLV was a surgical procedure for heart failure, with peak performance around 1998.

Purpose of the Study:

To identify factors influencing event-free survival after partial left ventriculectomy.
To understand the evolution and current status of PLV.

Main Methods:

Analysis of a large international registry of voluntary partial left ventriculectomy (PLV) cases.
Statistical evaluation of patient demographics, surgical factors, and outcomes.

Main Results:

Event-free survival was not affected by patient demographics, ventricular characteristics, or mitral regurgitation.

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Poor preoperative condition (NYHA class IV, low contractility, emergency surgery), early surgical dates, lack of experience, and extensive resection were linked to worse outcomes.

PLV use declined globally by 2000, except in Asia where it's performed by experienced centers on better-conditioned patients.

Conclusions:

Avoiding specific risk factors can improve survival and aid in patient risk stratification for PLV.
Combined approaches with circulatory assist devices may enhance outcomes for dilated heart failure.
The principle of ventricular volume reduction persists in newer, less invasive procedures.