Heterogeneous immediate effects of partial left ventriculectomy on cardiac performance

Partial left ventriculectomy (PLV) is a novel surgical treatment for severe heart failure consisting of resection of a large wedge of myocardium to reduce wall stress and restore the normal mass-volume ratio. Although ejection fraction (EF) has been shown to improve after PLV, few other physiologica...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1998-03, Vol.97 (9), p.839-842
Main Authors: GORCSAN, J. III, FELDMAN, A. M, KORMOS, R. L, MANDARINO, W. A, DEMETRIS, A. J, BATISTA, R. J. V
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cardiac Volume
Cardiology. Vascular system
Female
Heart
Heart Failure - physiopathology
Heart Failure - surgery
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart Ventricles - surgery
Humans
Male
Medical sciences
Middle Aged
Myocardial Contraction
Stroke Volume
Ventricular Dysfunction, Left - surgery
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Summary:Partial left ventriculectomy (PLV) is a novel surgical treatment for severe heart failure consisting of resection of a large wedge of myocardium to reduce wall stress and restore the normal mass-volume ratio. Although ejection fraction (EF) has been shown to improve after PLV, few other physiological data describing its immediate effects on left ventricular (LV) performance are available. Eight patients, 58+/-5 years old, with severe clinical heart failure and EF of 12+/-3% were studied before and immediately after PLV. LV performance was assessed by the predominantly load-insensitive measures of pressure-area relations with high-fidelity pressure catheters and transesophageal automated echocardiographic measures of cross-sectional area as a surrogate for volume. LV end-diastolic volume decreased from 200+/-60 to 89+/-17 mL, EF increased from 12+/-3% to 41+/-8%, and right ventricular (RV) fractional area change increased from 24+/-12% to 37+/-16% (all P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.97.9.839