Partial left ventriculectomy for infantile ischemic cardiomyopathy caused by anomalous origin of the left coronary artery from the pulmonary artery

Posterior ventricular restoration treatment for heart failure: a review, past, present and future aspects

Congestive heart failure (CHF) is one of the major causes of death and occurs in more than 15,000,000 patients worldwide. The incidence is expected to increase in parallel with the aging population. Most current therapies for CHF are medications, and biventricular pacing implantation as appropriated by cardiologists, or surgical interventions. The heart transplantation for indicated patients is still gold standard surgery although the 10-year survival rate is approximately 60% based on the worldwide data. However, the cardiac transplantation remains epidemiologically insignificant because of donor pool limitations. New strategies for treating CHF are needed. In addition to conventional cardiac surgery, surgical ventricular restoration was reported as a promising surgical therapy in 1990s. After the first report of partial left ventriculectomy in which posterior wall was widely resected for dilated heart, many controversial clinical and animal research studies have been reported. In this review, the principles of posterior cardiac restoration therapy will be discussed. An overview of posterior cardiac restoration, structure, and torsion are presented. By understanding the structure of cardiac muscle, shape, and torsion of left ventricle for surgical restoration, the procedure can be performed based on appropriate indication and this knowledge can be used to optimize and improve its efficacy. The use of mechanical support devices has recently become commonplace in many centers, and the use of implantable ventricular assist devices as destination therapy will increase. Surgeons will be able to select several options of the treatment for CHF by understanding the advantages and disadvantages of those surgical treatments.

Batista Procedure for a Coronary Anomaly in an Infant: Long-Term Follow-Up

A partial left ventriculectomy (Batista operation) is extremely unusual in infants. Follow-up data are unknown. We report the findings at long-term follow-up in an infant after the Batista procedure, following reimplantation of an anomalous coronary artery. The initial approach and options for management are discussed, along with late cardiac remodeling. doi: 10.1111/jocs.12775 (J Card Surg 2016;31:556-558).

Partial Left Ventriculectomy: Have Well-Succeeded Cases and Innovations in the Procedure Been Observed in the Last 12 Years?

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.

Use of the Batista procedure to discontinue bypass following aortic reimplantation of an anomalous left coronary artery

A four-month-old infant with anomalous origin of the left coronary artery from the pulmonary artery developed severe left ventricular failure after aortic reimplantation, despite prolonged supportive cardiopulmonary bypass with high level inotropic support and several abortive attempts for discontinuation. The Batista procedure was performed and the patient was successfully weaned from bypass. Postoperative recovery was uneventful, and at one-year follow-up she remains asymptomatic.