Intermediate‐term Results of Partial Left Ventriculectomy

Abstract

Abstract Partial left ventriculectomy (PLV) has been introduced as an option for patients with end‐stage dilated cardiomyopathy. We report the result of a prospective trial of PLV in patients with idiopathic dilated cardiomyopathy, left ventricular end‐diastolic diameter (LVEDD) > 7 cm, refractory New York Heart Association (NYHA) Class IV symptoms, and depressed exercise oxygen consumption studies. Sixteen patients underwent a PLV with a mean follow‐up of 13 months. Fourteen patients were male. Mean age was 49.6 ± 10.5 years (range 30 to 67 years). Left ventricular ejection fraction (LVEF) improved after surgery from 13.9 ± 5.6 to 21.0 ± 8.4, and this improvement persisted for up to 12 months after operation. LVEDD and NYHA Class also were significantly improved after surgery and for up to 12 months of follow‐up. Operative mortality was 6.25%. Twelve‐month survival was 86% by Kaplan‐Meier analysis. Four (25%) of 16 patients that had initial improvement after PLV developed recurrent heart failure and were listed for transplantation. Freedom from need for listing for heart transplantation was 65% at 12 months. Freedom from death or the need for relisting at 12 months was 56%. PLV can be performed with acceptable early and 12‐month mortality. Significant improvements in LVEF, LVEDD, and NYHA Class are seen at up to 12 months of follow‐up. Some patients will develop recurrent heart failure and require relisting for heart transplantation.