ventricular remodeling

Posted By  CCF Cardio MD- SGM on September 04, 1997 at 19:44:08:

In Reply to: ventricular remodeling posted by Jon on September 02, 1997 at 18:32:06:

: I have noticed that the Batista procedure usually includes valve repair, both in Dr. Batista's clinic and at the Cleveland Clinic. Do patients with idiopathic dilated cardiomyopathy and CHF benefit from the procedure if their valves are not yet failing? I understand that long term results are not available but please answer as best you can.

[CCF Cardio MD-SGM]

Dear Jon,
As you note, the Batista procedure, or left ventricular remodelling surgery, is a new and experimental
therapy for severe, debilitating dilated cardiomyopathy.  Candidates include patients who have failed
conventional medical therapy with ACE inhibitors, diuretics, and digoxin.  At the Cleveland Clinic,
ventricular remodeling surgery is most commonly used as an adjunctive treatment to heart transplant,
in that remodeling surgery patients may be placed on the transplant waiting list, should the surgery
not be successful in improving their quality of life.  
In dilated cardiomyopathy, the ventricular dimensions and geometry are altered so that inevitably,
some degree of mitral valvular regurgitation, or leakage, is present.   As part of the standard
Batista procedure, a suture is placed across the mitral valve orifice to limit this leakage.  The surgery
may well be beneficial, however, in the absence of severe mitral regurgitation.  
I think it's important to note again that this is an experimental procedure whose success has not
yet been proven in large clinical studies.  These investigations are ongoing, and the results will
likely be available in the near future.  For the time being, maximal medical therapy and then
cardiac transplantation remain the cornerstones of treatment for severe congestive heart failure
due to dilated cardiomyopathy.  
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).