This is also known as the Batista procedure and left ventricular partial ventriculectomy.
It is a new, experimental procedure used for patients with dilated, weak hearts whose symptoms cannot be controlled with medications and whose condition cannot be improved with other surgical procedures.
The chambers of the heart often enlarge in response to a variety of heart diseases. This enlargement often helps the heart pump blood normally in the face of the underlying heart disease.
However, sometimes the heart chambers enlarge too much. This excessive enlargement can make it more difficult for the heart to pump blood adequately.
Left ventricular partial ventriculectomy addresses this problem by reducing the size of the main pumping chamber of the heart-the left ventricle.
It is done in the standard fashion for open heart surgery. The patient is under general anesthesia with cardiopulmonary bypass. The heart is allowed to continue to beat while the procedure is performed.
A portion of the heart muscle is removed from the back of the heart. This makes the pumping chamber of the heart smaller and allows it to function more efficiently. Many patients eligible for this procedure also have a leaky mitral valve which can be repaired or replaced at the same time.
The procedure is generally reserved for patients who seem certain to die otherwise. The most promising results seem to be reserved for people whose weak heart muscle is not due to blocked coronary arteries.
The largest experience in this procedure in the United States comes from the Cleveland Clinic Heart Center. Their results to date (December, 2000) are not favorable. Only 78% of patients surviving the surgery are alive one year later and only 68% are alive 2 years later. Only 50% of surviving patients are alive and free of any serious setbacks one year after the operation. This percentage drops to 37% at two years. Patients who do survive without any serious setbacks have only a modest improvement in the functioning of their hearts and in their symptoms.
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