Partial Left Ventriculectomy to Treat End-Stage Heart Disease

Batista, Randas J.V.; Verde, José L; Nery, Paul; Bocchino, Lise; Takeshita, Noriaki; Bhayana, Joginder N.; Bergsland, Jacob; Graham, Susan; Houck, James; Salerno, Tomás A.

doi:10.1016/s0003-4975(97)00779-0

Cited by 343 publications

(181 citation statements)

References 3 publications

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“…1) Current treatment modalities, such as angioplasty and thrombolytic agents, are far from adequate. [2][3][4] Cardiac tissue engineering is one of the new therapies for myocardial infarction. 5) In native heart tissue, cardiac cells metabolize very actively, and cell density is very high (abut 1.0 × 10 8 /cm 3 ).…”

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confidence: 99%

Culturing of Ventricle Cells at High Density and Construction of Engineered Cardiac Cell Sheets Without Scaffold

et al. 2009

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SummaryIn natural heart tissue, cell density is about 1.0 × 10 8 /cm 3 , and the cell metabolism is very active. Therefore, culturing heart cells in 3-dimensions at high density and construction of engineered cardiac tissue in vitro is very difficult. The aim of this study was to simulate 3-dimensional culturing of cardiac cells and pursue a novel method to construct engineered cardiac tissue in vitro. The isolated neonatal rat ventricle cells were cultured at a high seeding density of 1 × 10 6 /cm 2 . The cells at high density metabolized actively;the glucose consumption and lactic acid production of ventricle cells were much greater than those of fibroblasts cultured at the same density. The pH value of the culture medium of ventricle cells consistently decreased more rapidly. These cultured ventricle cells contained vascular endothelial cells, cardiomyocytes, and smooth muscle cells that appeared close to each other, and had overlapping nuclei and plenty of extracellular collagen. The cells at high density were treated with 0.2% trypsin to construct engineered cardiac cell sheets without scaffold. The engineered cardiac cell sheets could beat and roll up spontaneously, each sheet was 3 to 5 cells thick, and contained abundant cardiomyocytes and extracellular collagen.In conclusion, cells cultured at high-density in vitro grew well in a 2-dimensional culturing environment, formed "quasi 3-dimension" culturing, and engineered cardiac cell sheets comprised of several layers of cells were constructed. This study provides some guidance for cardiac tissue engineering and a novel method to construct engineered cardiac tissue without scaffold. (Int Heart J 2009; 50: 653-662)

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confidence: 99%

Culturing of Ventricle Cells at High Density and Construction of Engineered Cardiac Cell Sheets Without Scaffold

et al. 2009

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“…7 The principle underlying this partial left ventriculectomy is related to LaPlace's law; that is, to reduce the wall tension by shortening the diameter of the left ventricle. Batista reported 120 surgical patients with 30-day mortality rates of 22% and 2-year survival rates of 55%.…”

Section: Discussionmentioning

confidence: 99%

Congenitally Corrected Transposition of the Great Arteries Treated by Partial Systemic Ventriculectomy.

Kobashi

Suwa

Nakamura

et al. 2003

Circ J

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42-year-old man was admitted to hospital with worsening dyspnea. At the age of 18, he underwent annuloplasty of the systemic AV valve for severe valvular regurgitation related to CCTGA at another hospital and did not have any problems on follow-up until age 33 when he visited hospital with paroxysmal nocturnal dyspnea. Because the systemic AV valve regurgitation had recurred to a severe degree and systemic ventricular contraction had decreased, he underwent systemic AV valve replacement and annuloplasty of the pulmonary AV valve. At age 39, atrial fibrillation with a rapid heart rate developed and could not be controlled with medications, so the His-bundle was cryoablated to block AV conduction and a permanent rate-adaptive pacemaker inserted intravenously. Although he was controlled in all pacemaker rhythm without tachycardia, his systemic ventricular function decreased and he was in New York Heart Association (NYHA) functional class 4 even after receiving digitalis, diuretics, angiotensin-converting enzyme inhibitor (ACEI) and other oral inotropic agents.His height was 185 cm and body weight was 75 kg. His blood pressure was 116/60 mmHg and the pulse rate was 60 beats/min and regular. Auscultation showed no significant murmur. Electrocardiograms revealed all pacemaker rhythm (VVI). Chest X-rays showed a cardiothoracic ratio of 58% and systemic atrial and ventricular enlargement. Echocardiography revealed enlargement of the systemic atrium and ventricle, and reduction of the systemic ventricular systolic function (the left atrial dimension was 4.7 cm, the end-diastolic dimension of the systemic ventricle was 8.6 cm and the fractional shortening was 14%) ( Table 1, Fig 1). Pulmonary wedge pressure and right-side pressures were elevated ( Table 2). The systemic ventriculogram showed diffused hypokinesis, but myocardial perfusion imaging using technetium-99m tetrofosmin indicated a severe perfusion defect in the lateral wall and the apex at rest.Because his symptoms could not be relieved by medical treatment, he was transferred to Shonan Kamakura General Hospital to undergo partial systemic ventriculectomy in February 1998. Under cardiopulmonary bypass (CPB) with heart beating and without aortic cross-clamping, the systemic ventricle was incised laterally from the apex to the base. There was neither mitral apparatus nor recognizable papillary muscle because of the previous valve replacement. Much of the anterolateral wall that was thin and akinetic on intraoperative palpation, and which corresponded to the defect on perfusion imaging, was excised in a tear-drop shape (7 cm wide and 12 cm long, 66 g in weight). Closure of the ventricle was done in 2 layers. The duration of CPB was 73 min and ventricular function recovered well without mechanical support. The resected myocardium had severe interstitial fibrosis (28.5%) and mild degeneration and hypertrophy of the myocardial cells.On echocardiography, the end-diastolic dimension of the systemic ventricle decreased to 5.7 cm, but the ejection fraction (EF) had not cha...

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“…It became well known internationally when he presented his experience at the STS meeting in 1997. 1 In 120 patients who underwent PLV, most patients had New York Heart Association (NYHA) class IV heart failure because of dilated cardiomyopathy of various causes. The 30-day mortality was 22% and the 2-year survival rate was 55%.…”

Section: Batista's Plvmentioning

confidence: 99%