Re: Batista Procedure

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Posted by CCF-CARDIO MD sc on August 31, 1997 at 09:29:57:

In Reply to: Batista Procedure posted by Bill on August 27, 1997 at 09:31:13:

: Good Morning:

Last night I was watching the news and caught the tail end of a story about the Batista Procedure, which I believe stated that the "dead" portion of a person's heart can be removed. The news story said that this procedure is being done at The Cleveland Clinic. Can you tell me more about it? Is this appropriate for patients whose MI's have left a portion of their heart "dead"?

Thank you so much for giving us a place to ask our questions!!

Bill

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Dear Bill
Thank you for your nice comments, the questions you have asked are very timely considering all the publicity this procedure is receiving in the lay press. As you might have seen on the news report you have mentioned this procedure was pioneered by Dr Batista a Brazilian surgeon who was practicing in the heartland of Brazil where most of his patients did not have the luxury of first class medical care most patients in the US have. Although not given much credence by the medical community he did finally manage to present his findings at a Chest conference. The way he managed to do this is a story in its own right. What Dr Batista proposes is that when a heart is dilated ( enlarged ) beyond a certain point the dynamics of contraction are altered making the pumping of the heart less efficient. What he embarked to do was to resect a portion of the dead heart ( the lateral wall ) in an attempt to achieve more favorable geometry for cardiac contraction. The procedure has been performed in the Clinic for about a year and a half now after 2 of our Physicians Dr P. McCarthy and Dr R. Starling had gone do to Brazil to see Dr. Batista at work first hand.
Apart from the procedure described Dr. McCarthy has continued to improve the procedure by his own technique whereby he also attempts to combine the Left ventricular reduction with repair of the mitral valve. The valve which separates the top and bottom chambers of the heart on the left side which tends to leak backward when the heart is dilated further decreasing the efficiency of the heart. Thanks to our wonderful surgeons and our heart failure group The Cleveland Clinic has one of the vastest experiences in this procedure. However there are there are many questions that need to be answered. First of all this procedure is reserved for those patients whose heart is not effected by ischemic heart disease ( disease of the heart caused by narrowing of the heart arteries and heart attacks ), so this would answer your question on the possibility of having this done in somebody who has had damage to his heart after a heart attack.
Secondly and more importantly not all patients seem to do well with this procedure and The Cleveland Clinic is still striving to find the clinical profile of the patients who are destined to do well. In our experience so far we have seen that a third tend to significantly improve from a clinical standpoint, a third remain the same and a third having their disease progress with some going on to left ventricular assist devices and cardiac transplantation. It is this point that makes it so important that this procedure is only attempted at centers where these facilities of cardiac transplantation and assist devices are readily available.
I hope this has helped clarify some of you questions, if you have any further questions or would like to be seen by our Heart Failure Group here at The Cleveland Clinic please feel free to call 1-800-CCF-CARE for an appointment.

Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your family physician(s).

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