PARTIAL LEFT VENTRICULECTOMY TO TREAT END-STAGE HEART-DISEASE

Background. It is reasoned that reducing left ventricular diameter (La place's law) in patients with dilated cardiomyopathy, will improve ven tricular function. Methods. Partial left ventriculectomy was performed in 120 patients with end-stage dilated cardiomyopathies of varying ca uses. Most patients were in New York Heart Association functional clas s IV. The procedure consisted of removal of a wedge of left ventricula r muscle from the apex to the base of the heart. Depending an the dist ance between the two papillary muscles, the mitral valve apparatus was either preserved, repaired, or replaced with a tissue prosthesis. Res ults. The 30-day mortality was 22% and the 2-year survival was 55%. Al though 10% of surviving patients skewed no improvement in New York Hea rt Association functional class, mast of the surviving patients were i n either class I (57%) or II (33.3%), and the others were in class III and IV. Conclusions. Partial left ventriculectomy earn be used to tre at end-stage dilated cardiomyopathy. Further studies and a longer foll ow-lap period are needed to fully assess the effects of this procedure . (C) 1997 by The Society of Thoracic Surgeons.