Long-term follow-up of patients undergoing isolated partial left ventriculectomy

This study aimed at providing a 6-year follow-up of patients undergoing partial left ventriculectomy because the long-term clinical course of patients who undergo this procedure is unknown.

From February 1995 to October 1997, 14 consecutive patients underwent partial left ventriculectomy at our institution. Surviving patients were followed as of February 2001. Partial left ventriculectomy was performed on a beating heart without cardioplegia. Neither coronary revascularization nor mitral valve surgery were performed in any patient. Mean age of patients was 48 +/- 12 years. Before the procedure, all patients were in New York Heart Association functional class (NYHA) IV. Seven (50%) patients were operated on inotropic support. On echocardiography, mean left ventricular diastolic dimension was 81.7 +/- 11.9 mm. Mean left ventricular ejection fraction was 16.7 +/- 5.2%. Four (28%) patients died in the postoperative period. Of the 10 surviving patients, 6 (60%) died during the first year of follow-up: 3 died suddenly, 2 of cardiogenic shock precipitated by infection, and 1 of intractable arrhythmia associated with gastrointestinal haemorrhage. At 2-year follow-up, 1 patient died of cerebrovascular accident, whereas another patient died of cardiogenic shock precipitated by infection at 3-year follow-up. Two (20%) patients of the original cohort are still alive: 1 is on the waiting list for heart transplantation, whereas the other is doing well. Probability of survival at 1-year, 2-year, 3-year and 6-year follow-up was 29%, 22%, 15% and 15%, respectively.

Isolated partial left ventriculectomy seems not to be an adequate treatment for end-stage heart failure in view of poor patients survival on long-term follow-up.