The Batista procedure (also called a reduction left ventriculoplasty) was an experimental heart procedure that proposed the reversal of the effects of remodeling in cases of end-stage
dilated cardiomyopathy
Dilated cardiomyopathy (DCM) is a condition in which the heart becomes enlarged and cannot pump blood effectively. Symptoms vary from none to feeling tired, leg swelling, and shortness of breath. It may also result in chest pain or fainting. Co ...
refractory to conventional medical therapy. The hypothesis of the operation appears to be that reduction (resection) of marginally viable ventricular mass may result in superior geometric remodeling thus conferring better performance when faced with ventricular failure. In spite of promising initial results, the method was soon found to be of little if any benefit, and it is no longer considered a recommended treatment for the disease.
The Batista procedure was invented by Brazilian physician and cardiac surgeon
Randas Batista in 1994 for use in patients with non-ischemic
dilated cardiomyopathy
Dilated cardiomyopathy (DCM) is a condition in which the heart becomes enlarged and cannot pump blood effectively. Symptoms vary from none to feeling tired, leg swelling, and shortness of breath. It may also result in chest pain or fainting. Co ...
. Many of his patients were victims of
Chagas disease. Chagas disease represents a parasitic nonischemic cardiomyopathy targeting parasympathetic inflow to the heart. Chagas cardiomyopathy thus represents a unique method of study of diastolic heart failure. It may be addressed by removal of a portion of viable tissue from the left ventricle to reduce its size (partial left ventriculectomy), with or without repair or replacement of the mitral valve.
Although several studies showed benefits from this surgery, studies at the
Cleveland Clinic
Cleveland Clinic is a nonprofit American academic medical center based in Cleveland, Ohio. Owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921, it runs a 170-acre (69 ha) campus in Cleveland, ...
concluded that this procedure was associated with a high early and late failure rate. At 3 years only 26 percent were event-free and survival rate was only 60 percent.
Most hospitals in the US have abandoned this operation and it is no longer included in heart failure guidelines.
References
External links
Chapter 69: Nontransplant Surgical Options for Heart Failureby Martinus T. Spoor and Steven F. Bolling in ''Cardiac Surgery in the Adult'']
Cardiac surgery
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