Partial left ventriculectomy (Batista procedure) in the treatment of dilated cardiomyopathy: Makati Medical Center Philippine experience

In the Philippines patients with end-stage heart disease refractory to conv entional medical and surgical treatment do not have alternative choices. Mo re than 99% of the population cannot afford cardiac transplantation. Partia l left ventriculectomy (PLV) is a surgical procedure that improves cardiac function and refractory congestive heart failure (CHF). Between October 199 7 and February 1998 eight patients had PLV at the Makati Medical Center, Ph ilippines. All patients had end-stage dilated cardiomyopathy. Six patients had an idiopathic etiology, one was ischemic and one valvular. Seven of eig ht operations were done with the heart beating and all had transesophageal echo monitoring. An average of a 2-cm reduction in the left ventricle diame ter was achieved and ejection fraction improved in all cases. There were no operative deaths. There were three late deaths. Two patients died of refra ctory CHF and ventricular arrhythmias and one patient died of massive cereb ral hemorrhage with coumadin therapy. The five survivors are all doing well with no CHF. Follow-up two-dimensional echo shows stable left ventricular (LV) size and improved ejection fraction. Our initial experience shows that PLV, at least in the short-term, has beneficial effects in the treatment o f end-stage dilated cardiomyopathy and might become an alternative to cardi ac transplantation.