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The Batista Operation in Patients with Dilated Cardiomyopathy
Author(s) -
Isomura Tadashi,
Suma Hisayoshi,
Horii Taiko,
Sato Toru,
Kikuchi Norio,
Iwahashi Ken
Publication year - 1999
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1999.tb00963.x
Subject(s) - medicine , dilated cardiomyopathy , ejection fraction , heart failure , cardiopulmonary bypass , cardiology , inotrope , mitral regurgitation , regurgitation (circulation) , surgery
Abstract Between December 1996 and October 1998,34 patients with nonischemic dilated cardiomyopathy (DCM) received cardiac volume reduction surgery. The patients' ages ranged from 14 to 67 years (mean = 48 years) and included 28 males and 6 females. Associated mitral regurgitation was present in 31 patients, tricuspid regurgitation in 19 patients, and aortic regurgitation in 4 patients. We performed a partial left ventriculectomy (PLV) using antegrade intermittent warm blood cardioplegia in 15 patients (group A), and in 19 patients (group B) PLV was performed using the on‐pump beating heart technique. In group A, the mean aortic clamping time was 79 ± 33 minutes and the total cardiopulmonary bypass time was 155 ± 58 minutes. In group B the mean cardiopulmonary bypass time was 121 ± 43 minutes. There were eight hospital deaths (five in group A and three in group B). Five of 10 survivors of group A required inotropic support for 13.8 ± 25.3 days after the operation, while 5 of 12 survivors in group B required inotropes for 4.2 ± 3.1 days. Hospital mortality was 86% in 7 emergent cases and 7% in 27 elective cases. Echocar‐diographic study showed that the left ventricular ejection fraction improved from a mean of 18.7% to 30.3% and the left ventricular diameter decreased from a mean of 80.2 mm to 62.3 mm after the operation. All 26 hospital survivors were followed for 1 to 20 months. Three patients died at early follow‐up because of congestive heart failure, thrombosed valve, and hepatic failure, respectively. Nineteen patients were in New York Heart Association (NYHA) Class I or II and four were in NYHA Class III. In conclusion, cardiac volume reduction surgery is effective when the operative technique and proper judgment of patient selection are established, and emergent operation is avoided.