Heterogeneous immediate effects of partial left ventriculectomy on cardiac performance

Abstract

Background - Partial left ventriculectomy (PLV) is a novel surgical treatment for severe heart failure consisting of resection of a large wedge of myocardium to reduce wall stress and restore the normal mass-volume ratio. Although ejection fraction (EF) has been shown to improve after PLV, few other physiological data describing its immediate effects on left ventricular (LV) performance are available. Methods and Results - Eight patients, 58 ± 5 years old, with severe clinical heart failure and EF of 12 ± 3% were studied before and immediately after PLV. LV performance was assessed by the predominantly load-insensitive measures of pressure-area relations with high- fidelity pressure catheters and transesophageal automated echocardiographic measures of cross-sectional area as a surrogate for volume. LV end-diastolic volume decreased from 200 ± 60 to 89 ± 17 mL, EF increased from 12 ± 3% to 41 ± 8%, and right ventricular (RV) fractional area change increased from 24 ± 12% to 37 ± 16% (all P