Intermediate-term results after partial left ventriculectomy for end-stage dilated cardiomyopathy: Is there a survival benefit?

Steven W. Etoch, Patricia Cerito, Betty J. Henahan, Laman A. Gray, Robert Dowling

Research output: Contribution to journalArticle

8 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)153-158
Number of pages6
JournalJournal of Cardiac Surgery
Volume16
Issue number2
DOIs
StatePublished - Jan 1 2001

Fingerprint

Dilated Cardiomyopathy
Survival
Heart Failure
Heart Ventricles
Mortality
Transplantation
Kaplan-Meier Estimate
Oxygen Consumption
Survival Rate
Clinical Trials
Exercise
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Etoch, Steven W. ; Cerito, Patricia ; Henahan, Betty J. ; Gray, Laman A. ; Dowling, Robert. / Intermediate-term results after partial left ventriculectomy for end-stage dilated cardiomyopathy : Is there a survival benefit?. In: Journal of Cardiac Surgery. 2001 ; Vol. 16, No. 2. pp. 153-158.
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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.",
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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 journalArticle

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