Partial left ventriculectomy: Have well-succeeded cases and innovations in the procedure been observed in the last 12 years?

Abstract

OBJECTIVE In 1996, the Brazilian cardiovascular surgeon, Dr. Randas Batista, introduced a surgical technique called partial left ventriculectomy, where he admitted the possibility of reducing the diameter of the left ventricle through the sectioning of one section of its wall. After the publication of this study, thousands of case reports and procedure analysis have been published, and due to several disappointing results, many doctors and institutions failed to execute it. As the main objective of this study, stands out the search for success cases of ventriculectomy in the last 12 years and if during this period it was achieved some significant development in this procedure that allows obtaining lower mortality rate postoperatively.METHODS Systematic review of indexed scientific literature over the past 12 years and the term "Partial Left Ventriculectomy".RESULTS There has been a considerable number of reported successful cases and highly significant findings in regard to determining the most suitable region for the section, proper selection of the patients indicated to the procedure, including the influence of the coronary artery anatomy in the nomination procedure and the need for preservation of ventricular geometry to ensure better quality of ventricular contractions after the sectioning.CONCLUSION This surgical procedure has been successfully performed, mainly in Japan, improvements in its efficiency were found and the need for a mathematical modeling of the slice to be severed is a prominent factor in many studies.

New Mathematical Model for the Surface Area of the Left Ventricle by the Truncated Prolate Spheroid

“…A σ ( S ) parameter may also be applied in carrying out the Partial Left Ventriculectomy (PLV), which is a surgical procedure based on the resection of a slice of the LV free wall from patients with dilated cardiomyopathy in an advanced stage, so that the LV diameter can be reduced and the systolic function can be restored. This surgical procedure had its performance drastically reduced worldwide, but, on the other hand, it has been performed with strict criteria of selection, especially in Japan, and one of the problems in its realization is the lack of determination methods of the dimensions of the slice to be removed [ 22 , 23 ]. Recently a mathematical model that allows this determination was developed and its practical application is basically dependent on the LV's surface area in normal patients [ 22 , 24 , 25 ].…”

Batista Procedure with the Aid of Intraoperative Epicardial Echocardiography

“…Although in many countries the Batista operation has been largely abandoned following a negative report from the Cleveland Clinic [4] , suitable patient selection and proper surgical technique may improve LV function and provide effective treatment [5] . Isomura Video3 -Performing Partial Left Ventriculectomy.…”

Fourteen Years' Survival After Batista Operation: The Short History of a Long Journey

“…PLV creation, several recent reports about its success rates have appeared, revealing a renewed interest on the subject. 5,[7][8][9][10] Patients with advanced DCM under clinical therapy may have poor quality of life and unfavorable longterm prognosis, with or without ventricular volume reduction surgery, but it is also significant that many patients submitted to Batista procedure has lived for months or years, with much better clinical status and cardiac function than before. In our opinion, PLV can still be performed in selected patients with advanced heart failure, refractory to pharmacological therapy, when heart transplant is not available.…”