Partial Left Ventriculectomy and Limited Heart Transplantation Availability |
| |
Authors: | Sini sa Gradinac,M.D.,Ph.D., Zoran Popovi ,M.D.,Ph.D., Milutin Miri ,M.D.,Ph.D., Jovan Vasiljevi ,M.D.,Ph.D., Stevan Nastasi ,M.D.,Ph.D., Miodrag Peri ,M.D.,Ph.D., Milovan Boji ,M.D.,Ph.D., Branislav Radovancevi ,M.D.,Ph.D.,&dagger O. Howard Frazier,M.D.,Ph.D.,&dagger |
| |
Affiliation: | Dedinje Cardiovascular Institute, Belgrade, Yugoslavia. gradinac@eunet.yu |
| |
Abstract: | BACKGROUND AND AIM: Partial left ventriculectomy, a novel cardiac volume reduction operation, is applied in countries without a developed heart transplantation program. We sought to determine its impact in our population of patients. METHODS: Partial left ventriculectomy was performed in 38 patients during the last 4 years. Basic inclusion criteria were nonischemic dilated cardiomyopathy and poor response to medical therapy for heart failure. Hemodynamic evaluation was carried out before and after operation. A modified surgical technique of mitral valve repair and ventricle suturing was applied. RESULTS: Thirty-day, 6-month, and 2-year survival rates were 82% +/- 7%, 65% +/- 8%, and 61% +/- 9%, respectively. Duration of heart failure symptoms was the only predictor of survival (p = 0.042). A high proportion of noncardiac causes of death was noted. Functional capacity in surviving patients improved at every successive measurement up to 1 year postoperatively. CONCLUSIONS: The introduction of partial left ventriculectomy in a country with limited heart transplantation availability had a great impact on the management of end-stage heart failure and may represent the only surgical option for some patients. The average cost per patient was substantially lower when compared to heart transplantation. |
| |
Keywords: | |
|
|