Procedure

Left ventricular volume reduction

Bristol Heart Institute, University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK

^* Corresponding author: ^* Tel.: +44-117-9283145; fax: +44-117-9299737. E-mail: r.ascione{at}bristol.ac.uk

The ‘left volume ventricular reduction’ operation was originally proposed by Dr Batista to reduce the diameter of the dilated left ventricle by excising a sizable amount of the ventricular free wall. Batista explains that the mechanism of cardiac improvement totally depends on La Place's law, therefore left ventricular wall tension is decreased by reducing the diameter leading to an increase in ejection fraction. Questions, however, still remain on diastolic function, preoperative judgement of left ventricular wall characteristics and late re-dilatation of the left ventricle. The operation was originally performed using normothermic cardiopulmonary bypass on the beating heart. Additional techniques with cardioplegic arrest, concomitant mitral valve repair, and closure of the left ventricle for improvement of hemostasis are shown.

Key Words: Left ventricular volume reduction • End-stage heart failure