Long-term follow-up of patients undergoing isolated partial left ventriculectomy

Abstract

Objective — This study aimed at providing a 6-year follow-up of patients undergoing partial left ventriculectomy because the long-term clinical course of patients who undergo this procedure is unknown.

Methods and results — From February 1995 to October 1997, 14 consecutive patients underwent partial left ventriculectomy at our institution. Surviving patients were followed as of February 2001. Partial left ventriculectomy was performed on a beating heart without cardioplegia. Neither coronary revascularization nor mitral valve surgery were performed in any patient. Mean age of patients was 48 ± 12 years. Before the procedure, all patients were in New York Heart Association functional class (NYHA) IV. Seven (50%) patients were operated on inotropic support. On echocardiography, mean left ventricular diastolic dimension was 81.7 ± 11.9 mm. Mean left ventricular ejection fraction was 16.7 ± 5.2%.

Four (28%) patients died in the postoperative period. Of the 10 surviving patients, 6 (60%) died during the first year of follow-up: 3 died suddenly, 2 of cardiogenic shock precipitated by infection, and 1 of intractable arrhythmia associated with gastrointestinal haemorrhage. At 2-year follow-up, 1 patient died of cerebrovascular accident, whereas another patient died of cardiogenic shock precipitated by infection at 3-year follow-up.Two (20%) patients of the original cohort are still alive: 1 is on the waiting list for heart transplantation, whereas the other is doing well. Probability of survival at 1-year, 2-year, 3-year and 6-year follow-up was 29%, 22%, 15% and 15%, respectively.

Conclusions — Isolated partial left ventriculectomy seems not to be an adequate treatment for end-stage heart failure in view of poor patients survival on long-term follow-up.

Key Words:

• heart failure
• congestive
• partial left ventriculectomy