Angiographic and hemodynamic follow-up of patients after partial left ventriculectomy
Akira T Kawaguchi1, Noriaki Takeshita, Lise Bocchino
1Tokai University School of Medicine, Isehara, Kanagawa, Japan. akira@is.icc.u-tokai.ac.jp
Insights
Partial left ventriculectomy (PLV) improved heart function by reducing end-systolic volume and increasing ejection fraction. Myocardial viability is crucial for successful PLV outcomes in heart failure patients.
Area of Science:
- Cardiovascular Surgery
- Cardiac Physiology
- Echocardiography
Background:
- Partial left ventriculectomy (PLV) is a surgical option for advanced heart failure.
- Assessing the functional impact of PLV on cardiac mechanics is essential.
Purpose of the Study:
- To evaluate the early and late effects of PLV on cardiac function.
- To determine the factors influencing PLV success.
Main Methods:
- Angiographic, Doppler-echocardiographic, and hemodynamic studies were performed.
- 24 patients undergoing PLV were assessed at 6 and 180 days post-surgery.
Main Results:
- PLV significantly decreased end-systolic volume more than end-diastolic volume.
- Stroke volume and ejection fraction were markedly improved post-PLV.
- Improved systolic contractility and reduced diastolic performance characterized successful outcomes.
Conclusions:
- PLV enhances cardiac performance by optimizing ventricular dimensions and contractility.
- Improved diastolic relaxation and myocardial viability are prerequisites for successful PLV.
- PLV offers a potential therapeutic strategy for select heart failure patients.
Abstract:
Angiographic, Doppler-echocardiographic and hemodynamic studies early (+6 days) and late (+180 days) after partial left ventriculectomy (PLV) on 24 patients revealed that PLV decreased end-systolic volume (or dimension) more than the end-diastolic volume (or dimension), improving stroke volumes (or contractile excursion), and doubling ejection fraction (or fractional shortening). Results of PLV appeared to depend on a balance between improved systolic contractility and reduced diastolic performance. All these survivors had improved diastolic relaxation, suggesting myocardial viability is a prerequisite for PLV to be successful.
