Partial left ventriculectomy in a child: 70-month clinical follow up

Abstract

Ventriculectomia parcial esquerda em criança: acompanhamento clínico por 70 meses Work performed in the institute of D.

Partial left ventriculectomy: Have well-succeeded cases and innovations in the procedure been observed in the last 12 years?

“…Yamagishi et al [ 10 ] and Westaby et al [ 11 ] present separately a female child case, one is 3 years old and the other is only 5 months old, both with ischemic DCM caused by anomalous origin of the left coronary artery of pulmonary artery, submitted to PLV. In both cases, and in agreement with the results of Souza et al [ 7 ] study, after performing the procedure, the kids have already presented very significant improvements in LV function, sharp reduction in the cavity volume and great improvement in FS. However, only Westaby et al [ 11 ] performed monitoring, and it is reported that in the last assessment the child was already 10 years old, in NYHA class I, played sports and had normal mental and physical development, showing great results at long term.…”

“…Another interesting study that indicates positive results after completion of the PLV, as the one presented by Sugiyama et al [ 5 ] is the study performed by Coelho de Souza et al. [ 7 ] . In his study, only one child diagnosed with idiopathic DCM has been undergoing the procedure and monitored for 70 months.…”

“…Souza et al [ 7 ] , in line with Sugiyama et al [ 5 ] believe the procedure should be considered for treatment, especially because it also works as a bridge to transplantation. It also improves significantly the child's life quality over a long period, including greater tolerance to physical activity.…”

“…[ 5 ] , Souza et al. [ 7 ] and Yamagishi et al [ 10 ] , analyzed the results of PLV completion in much larger samples, 70, 96, 107 and 36 patients, respectively, with global aged between 14 and 76 years, all in functional class III or IV by NYHA, and 83% of these also underwent mitral valve reimplantation. The determination of the region to be sectioned was made based on intraoperative echocardiography, by choosing the area which wall was thinner and akinetic.…”

“…In this evaluation, as well as performed in Horii et al [ 12 ] and Suma et al [ 13 - 15 ] , the area to be sectioned in the free wall of the LV, generally was that thinner and akinetic one, since this region does not contribute to the proper functioning of this cavity. Some of the studies did not perform this stage, or at least did not report it [ 7 , 16 , 17 , 19 , 22 , 23 , 26 ] . In case some of them have not done this assessment, it may be that the sections have been made in kinetic regions, still leaving akinetic regions in the LV wall.…”