Abstract
Background: The mortality of congestive heart failure remains high despite advances in medical therapy. Partial left ventriculectomy (PLV) has been advocated as a surgical alternative for select patients with dilated cardiomyopathy. Methods: A prospective clinical trial of PLV for patients with end-stage idiopathic dilated cardiomyopathy was performed. Inclusion criteria were left ventricular end-diastolic diameter (LVEDD) greater than 7 cm, refractory New York Heart Association (NYHA) Class IV symptoms, and severely depressed exercise oxygen consumption. Results: Twenty patients underwent PLV with mean follow-up of 21.1 months. Sixteen were male; mean age was 50.1 years ± 12.0 years (range 25-67 years). Left ventricle (LV) ejection fraction improved after surgery from 14.1% ± 4.7% to 24.1% ± 3.1% (p < 0.05, t-test) and this improvement persisted up to 3 years after operation. LVEDD and NYHA Class also were notably improved. There were two early deaths for an operative mortality of 10% (2 of 20 patients). Nine patients after initial improvement in clinical status and LV function developed worsening congestive heart failure (CHF). Six of the 9 ultimately died of complications secondary to CHF. One-, 2-, and 3-year survival rates were 84%, 64%, and 40%, respectively, by Kaplan-Meier analysis. The other three patients required listing for transplantation because of recurrent NYHA Class IV symptoms. Freedom from death or the need for listing for transplantation at 1, 2, and 3 years was 65%, 53%, and 33%, respectively. The remaining nine patients all had improvement in their NYHA classification. Conclusions: PLV can be performed with acceptable early and intermediate term mortality; survival compares favorably to reports of similar groups of patients treated with medical therapy alone.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 153-158 |
| Number of pages | 6 |
| Journal | Journal of Cardiac Surgery |
| Volume | 16 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 1 2001 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Cardiology and Cardiovascular Medicine
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Intermediate-term results after partial left ventriculectomy for end-stage dilated cardiomyopathy : Is there a survival benefit? / Etoch, Steven W.; Cerito, Patricia; Henahan, Betty J.; Gray, Laman A.; Dowling, Robert.
In: Journal of Cardiac Surgery, Vol. 16, No. 2, 01.01.2001, p. 153-158.Research output: Contribution to journal › Article
TY - JOUR
T1 - Intermediate-term results after partial left ventriculectomy for end-stage dilated cardiomyopathy
T2 - Is there a survival benefit?
AU - Etoch, Steven W.
AU - Cerito, Patricia
AU - Henahan, Betty J.
AU - Gray, Laman A.
AU - Dowling, Robert
PY - 2001/1/1
Y1 - 2001/1/1
N2 - Background: The mortality of congestive heart failure remains high despite advances in medical therapy. Partial left ventriculectomy (PLV) has been advocated as a surgical alternative for select patients with dilated cardiomyopathy. Methods: A prospective clinical trial of PLV for patients with end-stage idiopathic dilated cardiomyopathy was performed. Inclusion criteria were left ventricular end-diastolic diameter (LVEDD) greater than 7 cm, refractory New York Heart Association (NYHA) Class IV symptoms, and severely depressed exercise oxygen consumption. Results: Twenty patients underwent PLV with mean follow-up of 21.1 months. Sixteen were male; mean age was 50.1 years ± 12.0 years (range 25-67 years). Left ventricle (LV) ejection fraction improved after surgery from 14.1% ± 4.7% to 24.1% ± 3.1% (p < 0.05, t-test) and this improvement persisted up to 3 years after operation. LVEDD and NYHA Class also were notably improved. There were two early deaths for an operative mortality of 10% (2 of 20 patients). Nine patients after initial improvement in clinical status and LV function developed worsening congestive heart failure (CHF). Six of the 9 ultimately died of complications secondary to CHF. One-, 2-, and 3-year survival rates were 84%, 64%, and 40%, respectively, by Kaplan-Meier analysis. The other three patients required listing for transplantation because of recurrent NYHA Class IV symptoms. Freedom from death or the need for listing for transplantation at 1, 2, and 3 years was 65%, 53%, and 33%, respectively. The remaining nine patients all had improvement in their NYHA classification. Conclusions: PLV can be performed with acceptable early and intermediate term mortality; survival compares favorably to reports of similar groups of patients treated with medical therapy alone.
AB - Background: The mortality of congestive heart failure remains high despite advances in medical therapy. Partial left ventriculectomy (PLV) has been advocated as a surgical alternative for select patients with dilated cardiomyopathy. Methods: A prospective clinical trial of PLV for patients with end-stage idiopathic dilated cardiomyopathy was performed. Inclusion criteria were left ventricular end-diastolic diameter (LVEDD) greater than 7 cm, refractory New York Heart Association (NYHA) Class IV symptoms, and severely depressed exercise oxygen consumption. Results: Twenty patients underwent PLV with mean follow-up of 21.1 months. Sixteen were male; mean age was 50.1 years ± 12.0 years (range 25-67 years). Left ventricle (LV) ejection fraction improved after surgery from 14.1% ± 4.7% to 24.1% ± 3.1% (p < 0.05, t-test) and this improvement persisted up to 3 years after operation. LVEDD and NYHA Class also were notably improved. There were two early deaths for an operative mortality of 10% (2 of 20 patients). Nine patients after initial improvement in clinical status and LV function developed worsening congestive heart failure (CHF). Six of the 9 ultimately died of complications secondary to CHF. One-, 2-, and 3-year survival rates were 84%, 64%, and 40%, respectively, by Kaplan-Meier analysis. The other three patients required listing for transplantation because of recurrent NYHA Class IV symptoms. Freedom from death or the need for listing for transplantation at 1, 2, and 3 years was 65%, 53%, and 33%, respectively. The remaining nine patients all had improvement in their NYHA classification. Conclusions: PLV can be performed with acceptable early and intermediate term mortality; survival compares favorably to reports of similar groups of patients treated with medical therapy alone.
UR - http://www.scopus.com/inward/record.url?scp=0035192421&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035192421&partnerID=8YFLogxK
U2 - 10.1111/j.1540-8191.2001.tb00501.x
DO - 10.1111/j.1540-8191.2001.tb00501.x
M3 - Article
C2 - 11766834
AN - SCOPUS:0035192421
VL - 16
SP - 153
EP - 158
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
SN - 0886-0440
IS - 2
ER -