Results of partial left ventriculectomy in patients with end-stage idiopathic dilated cardiomyopathy

Background: Partial left ventriculectomy has been recently introduced as a surgical therapy for end-stage heart failure. We performed a prospective st udy of partial left ventriculectomy in patients with end-stage idiopathic d ilated cardiomyopathy (IDCM). Methods: Patients considered as candidates for partial left ventriculectomy had IDCM, left ventricular end-diastolic diameter greater than 7 cm (LVEDD ), refractory New York Heart Association class IV symptoms (NYHA), and seve rely impaired exercise oxygen consumption. All patients underwent a complet e heart transplantation evaluation. Results: Partial left ventriculectomy was performed in 16 patients with a m ean follow-up of 11.1 months. Fourteen patients were male with a mean age o f 49.6 +/- 10.5 years. After surgery there were significant changes in NYHA class, left ventricular ejection fraction, LVEDD, and degree of mitral reg urgitation at up to 12 months follow-up. The operative mortality rate was 6 .25% and 12-month Kaplan-Meier was 86%. Twelve-month freedom from need for listing for orthotopic heart transplantation was 65%. Conclusion: Partial left ventriculectomy can be performed in patients with idiopathic cardiomyopathy with acceptable operative and 12 month survival r ates. Significant improvements are seen in ejection fraction, LVEDD, and NY HA class at 12 month follow up. Late failures do occur and some patients ha ve required relisting for transplant after partial left ventriculectomy.