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Sami S Kabbani
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Right arrow Congestive Heart Failure
Asian Cardiovasc Thorac Ann 2003;11:99-101
© 2003 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTIONS

Left Ventricular Volume Reduction Surgery in the Middle East

Sami S Kabbani, FACS, Mohammad Bashar Izzat, FRCS(CTh), Hisham Jamil, MD, Bassam Akasheh, FRCS1, Daoud Hanania, FRCS2, Hassan Raffa, MD3

Damascus University Cardiovascular Surgical Center, Syria
1 King Hussein Medical Center, Jordan
2 Arab Center for Heart and Special Surgery, Jordan
3 King Abdul-Aziz University, Saudi Arabia

For reprint information contact: Sami S Kabbani, FACS Tel: 963 11 2129437 Fax: 963 11 2129437 email: dam-uncv{at}net.sy Damascus University Cardiovascular Surgical Center, Damascus University, PO Box 2837 Damascus, Syria.

Heart transplantation is not yet socially acceptable in the Middle East, and left ventricular assist facilities are not generally available in this region. Therefore, left ventricular volume reduction surgery was attempted in 41 patients with end-stage heart failure (33 males; median age, 36.3 years) in 4 Middle Eastern tertiary referral centers between February 1996 and January 2001. Heart failure was due to idiopathic cardiomyopathy in 21 patients, ischemia in 11, rheumatic valvular disease in 8, and viral myocarditis in 1. Associated procedures were aortic valve replacement in 5 patients, mitral valve repair in 25, mitral valve replacement in 7, tricuspid valve repair in 6, and coronary bypass grafting in 8. Hospital mortality was 31.7%. Five patients were lost to follow-up. The survival rate of hospital survivors at 18 months was 65.2%. Three of the surviving patients did not benefit from the operation. Although our results were somewhat disappointing, this operation remains an option for surgeons working in developing areas of the world. It is hoped that better patient selection and new techniques of left ventricular volume reduction that avoid resection of viable muscle will further improve the outcome of this operation.






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