Giới thiệu suy tim giai đoạn cuối đang afiFects 1% những người dưới 55 tuổi, 9% người trên 80 tuổi, và dự kiến sẽ tiếp tục tăng trong phổ biến. Mặc dù cải tiến trong quản lý dược của suy tim với các đại lý mới hơn như các chất ức chế enzyme angiotensinconverting beta-blockers như carvedilol, | 9. PARTIAL LEFT VENTRICULECTOMY Richard J. Kaplon and Patrick M. McCarthy Introduction End-stage heart failure currently affects 1 of people under 55 yeans old 9 of people over 80 years old and is expected to continue to increase in Despite improvements in pharmacologic management of heart failure with newer agents such as angiotensinconverting enzyme inhibitors or beta-blockers such as carvedilol approximately 25 of patients die while awaiting heart 4 Even with attempts at expanding the donor pool through alternate recipient lists the limited number of hearts available for transplantation has 6 Ventricular-assist devices VAD have been effective as bridges to transplantation for those patients refractory to medical therapy however present use of VADs as destination therapy remains 9 Clinical attempts at cardiomyoplasty and xenotransplantation have thus far been generally Batista s Experience Based on his observations regarding the inter-relationship of heart mass and radius Dr. Randas Batista developed the procedure he termed partial left ventriculectomy PLV . In order to maintain a normal relationship an increase in ventricular cavitary radius must lead to an increase in ventricular wall mass. When radius increases without an appropriate increase in mass dilatation leads to clinical heart failure. According to the law of Laplace intraventricular pressure is proportional to mural tension and inversely related to chamber radius. Batista reasoned that reducing the radius by excising part of the ventricular wall would diminish mural tension improving overall left ventricular LV function and decreasing myocardial oxygen consumption. Batista first presented this work as a case report of a 34 year-old patient with New York Heart Association NYHA class IV heart failure who underwent The patient s ejection fraction EF rose from 17 pre-operatively to 44 at 2 months. Batista reported .
