ABSTRACT
Abstract A 41-year-old man with end-stage heart failure due to nonischemic dilated cardiomyopathy was submitted to the Batista procedure as an alternative to heart transplantation. With surgery, the patient showed progressive clinical amelioration, achieving long-term stable NYHA functional class II, despite gradual dilation of the heart chambers. Persistent atrial fibrillation appeared on the last year of life, his clinical condition deteriorated, and the patient died 14 years, four months, and 13 days after the operation. To the best of our knowledge this seems to be the longest reported survival for a patient submitted to Batista operation.
Subject(s)
Humans , Male , Adult , Ventricular Dysfunction, Left/surgery , Heart Failure/physiopathology , Atrial Fibrillation/complications , Survival , Cardiomyopathy, Dilated/surgery , Heart Ventricles/surgeryABSTRACT
Partial left ventriculectomy(PLV),also named as left ventricular volume reduction or the Batista procedure,is gradually used as a new alternative method to treat end-stage heart disease.This article summarizes the progress of the mechanism of partial left ventriculectomy with rapid left ventricle reshaping and hemodynamics change and patho-physiological effect etc.
ABSTRACT
Objective: Giant left ventricle is one of the important dangerous factors impacting the results of valve replacement operation.In order to improve the efficiency of operation,we summarized our experience in valve replacement surgery for patients with giant left ventricle(LVEDD ≥ 7.0 cm).Methods: We retrospectively analyzed the clinical data of 138 cases of giant left ventricle treated by valve replacement operation in our hospital from June 1996 to April 2008.The preoperative left ventricular end diastolic dimension(LVEDD),left ventricle end systolic dimension(LVESD),left ventricular ejection fraction(LVEF) and left ventricular fractional shortening(LVFS) were 7.38-10.51 cm(mean 7.98?0.39),5.20-7.93(mean 5.88 ? 1.03),0.21-0.66(mean 0.43 ? 0.11) and 0.10-0.45(mean 0.25 ? 0.07),respectively.Eighty-nine of the patients had the heart function(NYHA) of class Ⅲ,and the other 49 class Ⅳ.Mitral valve replacement(MVR) was performed for 57 cases,aortic valve replacement(AVR) for 26,double valves replacement(DVR) for 40,and Bentall operation for the other 15.Meanwhile,78 of them underwent tricuspid valve plasty(TVP),and another 17(LVEDD ≥8.5 cm and LVEF ≤ 25%) partial left ventriculectomy(PLV).Results: The early postoperative mortality rate was 5.8%,mainly due to postoperative multiple organ failure,severe low cardiac output syndrome and ventricular fibrillation.Compared with the preoperative data,postoperative echocardiography showed that LVEDD and LVESD were decreased slowly at 2 weeks,and LVEF and LVFS significantly improved at 6 months.In the 17 patients who underwent PLV,LVEDD and LVESD were significantly reduced at 2 weeks,and LVEF and LVFS markedly improved.Conclusion:The key to the efficiency of valve replacement for giant left ventricle was proper choice of the blood containing stop-beating fluid during the operation,preserving the posterior valve of the mitral valve and the structure beneath it,shortening aortic cross-clamping time as much as possible,and perioperative prevention and management of arrhythmia.The short-term effect of valve replacement with simultaneous PLV is satisfactory,while its long-term effect is yet to be further investigated.
ABSTRACT
The end-stage dilated cardiomyopathy is usually treated with cardiac transplantation although some limited success have also been obtained in selected patients using dynamic cardiomyoplasty or medical assist devices. Recently, a new surgical alternatives, called partial left ventriculectomy (PLV) was introduced by Randas J. V Batista in 1995. A 40-year-old man who had end-stage dilated cardiomyopathy refractory to optimal doses of medicines underwent partial left ventriculectomy (Batista's operation), which reduces ventricular volume to improve left ventricular function. The left ventricular ejection fraction increased from 20 % to 58 % at 4 month after operation.