Partial left ventriculectomy: The 2nd international registry report 2000

Akira T. Kawaguchi, Hisayoshi Suma, Wolfgang Konertz, Zoran Popovic, Robert Dowling, Soichiro Kitamura, Jacob Bergsland, Leonard M. Linde, Shirosaku Koide, Randas J.V. Batista

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Partial left ventriculectomy (PLV) has been performed without standardized inclusion or exclusion criteria. Methods: An international registry of PLV was expanded, updated, and refined to include 287 nonischemic cases voluntarily reported from 48 hospitals in 11 countries. Results: Gender, age, ventricular dimension, etiology, ethnology, myocardial mass, operative variation, presence or absence of mitral regurgitation, and transplant indication had no effects on event-free survival, which was defined as absence of death or ventricular failure that required a ventricular assist device or listing for transplantation. Preoperative patient conditions, such as duration of symptoms (> 9 vs < 3 years; p = 0.001), New York Heart Association (NYHA) class (Class IV vs < Class IV; p = 0.002), depressed contractility (fractional shortening [FS] < 5% vs > 12%; p = 0.001), and refractory decompensation that required emergency procedure (p < 0.001) were associated with reduced event-free survival. Five or more cases in each hospital led to significantly better outcomes than the initial four cases. Rescue procedures for 14 patients nonsignificantly improved patient survival (2-year survival 52%) over event-free survival (2-year survival 48%; p = 0.49), with improved NYHA class among survivors (3.6 to 1.8; p < 0.001). Outcome was better in 1999 than in all series before 1999 (p = 0.02) most likely due to patient selection, which was refined to avoid known risk factors such as reduced proportion of patients in NYHA Class IV, FS < 5%, and hospitals with experience in 10 or less cases. A combination of these risk factors could have stratified 17 high-risk patients with 0% 1-year survival and 26 low-risk patients with 75% 2-year event-free survival. Conclusion: Avoidance of risk factors appears to improve survival and might help stratify high- or low-risk patients. Although less symptomatic patients with preserved contractility had better results after PLV, change of indication requires prospective randomized comparison with medical therapies or other approaches.

Original languageEnglish (US)
Pages (from-to)10-23
Number of pages14
JournalJournal of Cardiac Surgery
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2001

Fingerprint

Registries
Disease-Free Survival
Survival
Ethnology
Heart-Assist Devices
Mitral Valve Insufficiency
Patient Selection
Survivors
Emergencies
Transplantation
Transplants

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Kawaguchi, A. T., Suma, H., Konertz, W., Popovic, Z., Dowling, R., Kitamura, S., ... Batista, R. J. V. (2001). Partial left ventriculectomy: The 2nd international registry report 2000. Journal of Cardiac Surgery, 16(1), 10-23. https://doi.org/10.1111/j.1540-8191.2001.tb00478.x
Kawaguchi, Akira T. ; Suma, Hisayoshi ; Konertz, Wolfgang ; Popovic, Zoran ; Dowling, Robert ; Kitamura, Soichiro ; Bergsland, Jacob ; Linde, Leonard M. ; Koide, Shirosaku ; Batista, Randas J.V. / Partial left ventriculectomy : The 2nd international registry report 2000. In: Journal of Cardiac Surgery. 2001 ; Vol. 16, No. 1. pp. 10-23.
@article{fbb08a3310644d0096734796c118609e,
title = "Partial left ventriculectomy: The 2nd international registry report 2000",
abstract = "Background: Partial left ventriculectomy (PLV) has been performed without standardized inclusion or exclusion criteria. Methods: An international registry of PLV was expanded, updated, and refined to include 287 nonischemic cases voluntarily reported from 48 hospitals in 11 countries. Results: Gender, age, ventricular dimension, etiology, ethnology, myocardial mass, operative variation, presence or absence of mitral regurgitation, and transplant indication had no effects on event-free survival, which was defined as absence of death or ventricular failure that required a ventricular assist device or listing for transplantation. Preoperative patient conditions, such as duration of symptoms (> 9 vs < 3 years; p = 0.001), New York Heart Association (NYHA) class (Class IV vs < Class IV; p = 0.002), depressed contractility (fractional shortening [FS] < 5{\%} vs > 12{\%}; p = 0.001), and refractory decompensation that required emergency procedure (p < 0.001) were associated with reduced event-free survival. Five or more cases in each hospital led to significantly better outcomes than the initial four cases. Rescue procedures for 14 patients nonsignificantly improved patient survival (2-year survival 52{\%}) over event-free survival (2-year survival 48{\%}; p = 0.49), with improved NYHA class among survivors (3.6 to 1.8; p < 0.001). Outcome was better in 1999 than in all series before 1999 (p = 0.02) most likely due to patient selection, which was refined to avoid known risk factors such as reduced proportion of patients in NYHA Class IV, FS < 5{\%}, and hospitals with experience in 10 or less cases. A combination of these risk factors could have stratified 17 high-risk patients with 0{\%} 1-year survival and 26 low-risk patients with 75{\%} 2-year event-free survival. Conclusion: Avoidance of risk factors appears to improve survival and might help stratify high- or low-risk patients. Although less symptomatic patients with preserved contractility had better results after PLV, change of indication requires prospective randomized comparison with medical therapies or other approaches.",
author = "Kawaguchi, {Akira T.} and Hisayoshi Suma and Wolfgang Konertz and Zoran Popovic and Robert Dowling and Soichiro Kitamura and Jacob Bergsland and Linde, {Leonard M.} and Shirosaku Koide and Batista, {Randas J.V.}",
year = "2001",
month = "1",
day = "1",
doi = "10.1111/j.1540-8191.2001.tb00478.x",
language = "English (US)",
volume = "16",
pages = "10--23",
journal = "Journal of Cardiac Surgery",
issn = "0886-0440",
publisher = "Wiley-Blackwell",
number = "1",

}

Kawaguchi, AT, Suma, H, Konertz, W, Popovic, Z, Dowling, R, Kitamura, S, Bergsland, J, Linde, LM, Koide, S & Batista, RJV 2001, 'Partial left ventriculectomy: The 2nd international registry report 2000', Journal of Cardiac Surgery, vol. 16, no. 1, pp. 10-23. https://doi.org/10.1111/j.1540-8191.2001.tb00478.x

Partial left ventriculectomy : The 2nd international registry report 2000. / Kawaguchi, Akira T.; Suma, Hisayoshi; Konertz, Wolfgang; Popovic, Zoran; Dowling, Robert; Kitamura, Soichiro; Bergsland, Jacob; Linde, Leonard M.; Koide, Shirosaku; Batista, Randas J.V.

In: Journal of Cardiac Surgery, Vol. 16, No. 1, 01.01.2001, p. 10-23.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Partial left ventriculectomy

T2 - The 2nd international registry report 2000

AU - Kawaguchi, Akira T.

AU - Suma, Hisayoshi

AU - Konertz, Wolfgang

AU - Popovic, Zoran

AU - Dowling, Robert

AU - Kitamura, Soichiro

AU - Bergsland, Jacob

AU - Linde, Leonard M.

AU - Koide, Shirosaku

AU - Batista, Randas J.V.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Background: Partial left ventriculectomy (PLV) has been performed without standardized inclusion or exclusion criteria. Methods: An international registry of PLV was expanded, updated, and refined to include 287 nonischemic cases voluntarily reported from 48 hospitals in 11 countries. Results: Gender, age, ventricular dimension, etiology, ethnology, myocardial mass, operative variation, presence or absence of mitral regurgitation, and transplant indication had no effects on event-free survival, which was defined as absence of death or ventricular failure that required a ventricular assist device or listing for transplantation. Preoperative patient conditions, such as duration of symptoms (> 9 vs < 3 years; p = 0.001), New York Heart Association (NYHA) class (Class IV vs < Class IV; p = 0.002), depressed contractility (fractional shortening [FS] < 5% vs > 12%; p = 0.001), and refractory decompensation that required emergency procedure (p < 0.001) were associated with reduced event-free survival. Five or more cases in each hospital led to significantly better outcomes than the initial four cases. Rescue procedures for 14 patients nonsignificantly improved patient survival (2-year survival 52%) over event-free survival (2-year survival 48%; p = 0.49), with improved NYHA class among survivors (3.6 to 1.8; p < 0.001). Outcome was better in 1999 than in all series before 1999 (p = 0.02) most likely due to patient selection, which was refined to avoid known risk factors such as reduced proportion of patients in NYHA Class IV, FS < 5%, and hospitals with experience in 10 or less cases. A combination of these risk factors could have stratified 17 high-risk patients with 0% 1-year survival and 26 low-risk patients with 75% 2-year event-free survival. Conclusion: Avoidance of risk factors appears to improve survival and might help stratify high- or low-risk patients. Although less symptomatic patients with preserved contractility had better results after PLV, change of indication requires prospective randomized comparison with medical therapies or other approaches.

AB - Background: Partial left ventriculectomy (PLV) has been performed without standardized inclusion or exclusion criteria. Methods: An international registry of PLV was expanded, updated, and refined to include 287 nonischemic cases voluntarily reported from 48 hospitals in 11 countries. Results: Gender, age, ventricular dimension, etiology, ethnology, myocardial mass, operative variation, presence or absence of mitral regurgitation, and transplant indication had no effects on event-free survival, which was defined as absence of death or ventricular failure that required a ventricular assist device or listing for transplantation. Preoperative patient conditions, such as duration of symptoms (> 9 vs < 3 years; p = 0.001), New York Heart Association (NYHA) class (Class IV vs < Class IV; p = 0.002), depressed contractility (fractional shortening [FS] < 5% vs > 12%; p = 0.001), and refractory decompensation that required emergency procedure (p < 0.001) were associated with reduced event-free survival. Five or more cases in each hospital led to significantly better outcomes than the initial four cases. Rescue procedures for 14 patients nonsignificantly improved patient survival (2-year survival 52%) over event-free survival (2-year survival 48%; p = 0.49), with improved NYHA class among survivors (3.6 to 1.8; p < 0.001). Outcome was better in 1999 than in all series before 1999 (p = 0.02) most likely due to patient selection, which was refined to avoid known risk factors such as reduced proportion of patients in NYHA Class IV, FS < 5%, and hospitals with experience in 10 or less cases. A combination of these risk factors could have stratified 17 high-risk patients with 0% 1-year survival and 26 low-risk patients with 75% 2-year event-free survival. Conclusion: Avoidance of risk factors appears to improve survival and might help stratify high- or low-risk patients. Although less symptomatic patients with preserved contractility had better results after PLV, change of indication requires prospective randomized comparison with medical therapies or other approaches.

UR - http://www.scopus.com/inward/record.url?scp=0034747888&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034747888&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8191.2001.tb00478.x

DO - 10.1111/j.1540-8191.2001.tb00478.x

M3 - Article

C2 - 11713852

AN - SCOPUS:0034747888

VL - 16

SP - 10

EP - 23

JO - Journal of Cardiac Surgery

JF - Journal of Cardiac Surgery

SN - 0886-0440

IS - 1

ER -