Intraoperative assessment of acute hemodynamic changes after partial left ventriculectomy

Partial left ventriculectomy (PLV) has been introduced as an alternative su rgical therapy for patients with end-stage dilated cardiomyopathy. The phys iological benefits of PLV are relatively unknown. Therefore, the objective of this study was to determine the acute effects of PLV by measuring cardia c function before and after PLV. Aortic and left ventricular pressures and aortic flow were measured in eight patients. Continuous, beat-to-beat data were recorded and compared pre-PLV and post-PLV with and without inferior v ena cava (IVC) occlusions. PLV increased cardiac output (0.93 +/- 0.5, p = 0.01) as a result of increased stroke volume (5.12 +/- 4.24, p = 0.06) and heart rate (14.5 +/- 8.44, p = 0.02). Contractility (+/- dP/dt, 240.33 +/- 74.28, p = 0.001) and external work (650.8 +/- 320.4, p = 0.01) were also i mproved. Left ventricular end-diastolic elastance (0.15 +/- 0.14, p = 0.10) nearly doubled after PLV. Our results indicated an improved cardiac functi on as measured by increased cardiac output, stroke volume, ejection fractio n (EF), and contractility.