Congestive Heart Failure, Cardiomyopathy

  Congestive Heart Failure runs in our family.  Five years ago. before it was diagnoised, Rheumatoid Arthritis attacked my heart leaving me with Cardiomyopathy.  I have only a 20% return from the heart.  I take Prednisone to control the RA, and Plaquinil for RA nodules.  Would I be a suitable candidate for new trial techneque of Dr.Randas Batista called,the
  left ventricular reduction surgery? My age is 61 and am female.

[CCF Cardio MD - MTR]

Dear Pat, thank you for your question.  First, I suggest that you read my
response to J.Gray's question on the same date as your question where
I mention the Batista procedure.  Next, I'll describe the procedure and
the poor results that have been found with it in the U.S.  The batista procedure
(also called left ventricular reduction surgery) involves removing a
portion of the dysfunctional LV tissue to improve the heart function by
altering the geometry and hemodynamics of the left ventricle.  Dr. Batista
has reported promising results from this procedure in Brazil, but his
research methods have been questioned, many of his patients are not followed
for the long-term, and the diseases that cause heart failure in his patients
are different than those in North America (Chagas' Disease - a parasite
infection of the heart muscle - is the main cause of congestive heart
failure in Brazil).  In the U.S., Dr. Patrick McCarthy of our institution
has been leading the research efforts regarding the Batista procedure.
He has found that most patients who undergo this procedure do not improve
and still require a heart transplant.  Now, there are a few isolated examples
of patients who do improve after a Batista, but most don't improve.  Thus,
we are now focusing our efforts on better medical treatment of CHF, better
mechanical assist devices for patients with severe CHF (J.Gray's question),
and improving the supply of donor organs in heart transplantation.   In your
case, there are many medications that may help you so I suggest that you
have a discussion with your cardiologist.  Also, if you have worsening
symptoms of shortness of breath, fatigue, and lower extremity swelling, you
should be evaluated by a physician soon.  It appears that medical treatments
will be the best option for you.  If you would like to be evaluated by
one of our heart failure physicians here, please call 1-800-CCF-CARE and ask
for an appointment in the CHF clinic, Desk F-25. I hope you find this information
useful.
Information provided in the heart forum is for general purposes only.
Specific diagnoses and therapies can only be provided by your physician.