Mid-term outcomes of left ventricular volume reduction surgery in pediatric patients with idiopathic dilated cardiomyopathy

Abstract

Objectives: The aim of this study was to report the early and mid-term outcomes of the left ventricular volume reduction surgery (LVVRS) and to carry out an observational analysis of prognostic factors related to early and late death after LVVRS, especially in pediatric patients with idiopathic dilated cardiomyopathy (DCMP). Methods: We reviewed the medical records of 10 patients (M:F = 5:5) under 19 years of age who had LVVRS for idiopathic DCMP between March 1997 and February 2014. We reviewed clinical characteristics, pre-and postoperative functional evaluation, and early/late postoperative mortality. Results: The mean age at diagnosis of idiopathic DCMP was 63.10 ± 44.39 (median 50, range 5.00-147.00) months and the mean age at the time of LVVRS was 83.30 ± 68.80 (median 63.5, range 14.00-210.00) months. The mean interval from diagnosis to LVVRS was 20.30 ± 35.34 (median 4, range 1.00-114.00) months. The failure of LVVRS was confirmed in seven cases. We defined failed LVVRS as death (n = 4) or heart transplant (n = 3) within two months of LVVRS. The most common cause of failed LVVRS was low cardiac output (n = 5, 71.4%), followed by ventricular tachycardia (n = 2, 28.6%). Conclusions: Although high mortality after LVVRS was noted in children with idiopathic DCMP, some patients had favorable mid-term outcomes. LVVRS might be considered as a bridge therapy to heart transplantation in young patients.