Myocardial fiber diameter as a good indicator of outcome in Batista's operation

Background: Despite the initial promissory results of partial left ventricu lectomy, or Batista's operation, the postoperative mortality associated wit h the procedure has been too high. We described a histopathologic study per formed to identify histological parameters that could help to determine out comes of patients undergoing this procedure. Methods and Results: Myocardia l fiber diameter, myocardial fibrosis, thickness of the compact wall, and n umber of cells presenting from the endocardium to epicardium were analyzed in 32 patients with idiopathic dilated cardiomyopathy who underwent Batista 's operation. Data were grouped by patients who died less than or equal to 6 months and patients who survived for > 6 months after the surgical proced ure. Additional analyses were performed to compare results according the ca uses of death and to test the application of these results to biopsy. Resul ts: Myocardial fiber diameter was the only index that could distinguish the two groups. Myocardial fiber diameter < 22 <mu>m distinguished the group o f patients who survived the B-month postoperative period from patients who died during that time with sensitivity of 85.7 and specificity of 72.2. The subendocardial region of the compact wall and the trabecular portion of th e wall exhibited comparable results. Conclusion: Our results indicate that the myocardial fiber diameter of samples from the trabecular or subendocard ial compact wall regions may help predict the outcome of left ventriculecto my. Samples from the trabecular or subendocardial compact wall regions were used for analysis. Further prospective studies involving left ventricular endomyocardial biopsies are necessary to confirm if the use of myocardial f iber diameter in the selection of patients for surgery improves the index o f success of Batista's operation. Other factors that are involved remain un clear.