197 Partial Left Ventriculectomy (Batista’s Procedure) Case Report: 40 Months Follow-Up Angelo Giuffrida, M.D., * Giuseppe Leonardi, M.D., * Fortunato Stimoli, M.D., † Tommaso Distefano, M.D., * Sergio Sciacca, M.D., ** Marco Mudan ` o, M.D., ** Eugenio Trimarchi, M.D., ** and Mauro Abbate, M.D. ** ∗ Divisione di Cardiochirurgia, Ospedale “Ferrarotto,” Catania, ∗∗ Istituto di Cardiochirurgia, Cattedra di Cardiochirurgia, Universit ` a degli Studi, Catania, † II Servizio di Anestesia e Rianimazione, Azienda Ospedali “Vittorio Emanuele,” “Ferrarotto” e “S. Bambino,” Catania ABSTRACT Objective: Partial left ventriculectomy (PLV) (also known as Batista’s Procedure) is a surgical procedure for treatment of dilated cardiomyopathy when cardiac transplant is contraindi- cated. Mitral valve replacement is needed because of mitral regurgitation as a consequence of annulus enlargement and papillary muscle resection. Bleeding and arrythmias are the main com- plications. Methods: We considered for this operation a 60-year-old male patient. He suffered from valvular dilating cardiomyopathy as a consequence of mitral and aortic valve regurgitation. Furthermore, a severe peripheral vascular disease treated with aortic-bifemoral prosthesis con- traindicated heart transplantation. He needed frequent hospital admissions for pulmonary edema and his quality of life was very poor. Batista’s procedure was performed in March 1998, success- fully. Mitral and aortic valves were replaced by use of mechanical prosthesis. The postoperative period was characterized by early weaning from ventilator and drugs; atrial fibrillation, reversed by Amiodaron; a little bilateral pleural effusion; and pacemaker implantation following advanced heart conduction block. No bleeding episodes were observed. In March 2001 the progression of the vascular disease forced the patient to undergo to a femoro-femoral bypass and endoarterec- tomy of the right branch of the vascular prothesis. The patient tolerated the procedure very well. He had no complications during the postoperative period with early weaning from ventilator and drugs. Results: At the end of the procedure ejection fraction raised from 15% to 30%. Echocar- diographic data demonstrated a slow but progressive improvement of the cardiac diameters and volumes with a preserved left ventricular function. Conclusion: Even if a larger number of cases and longer follow-up are necessary, our report demonstrated that Batista’s procedure should be considered as a surgical alternative to heart transplantation, in well-selected patients with ab- solute contraindication to heart transplantation and left ventricular assist device implantation. (J Card Surg 2003;18:197-200) INTRODUCTION Heart failure represents one of the main causes of death in industrialized countries. 1,2 The efforts Address for correspondence: Dr. Angelo Giuffrida, Piazza Don Bosco n ◦ 8, 95123 Catania, Italy. Fax: 0957436284; E-mail: giuftxct@tin.it in the last 20 years for improving the treatment of heart failure have been concentrated on the best choice to improve quality of life and survival. Heart transplantation represents the ultimate treatment in end-stage heart failure 3,4 and left ventricular assist sevice (LVAD) implantation is also becom- ing another very successful treatment option.