Batista Operation

About the Batista procedure

The Batista procedure was an experimental open-heart surgery that had been studied to reverse the effects of remodeling in cases of end-stage dilated cardiomyopathy. In this case, patients suffer from an enlarged left ventricle that cannot pump blood efficiently.

Though the Batista procedure seemed promising at first, it was later found to have little benefit and considerable risk. Today, the Batista procedure is not a recommended treatment for dilated cardiomyopathy. In this form of cardiomyopathy, the heart fails to respond to conventional therapy, and patients suffer from severe heart failure. However, while the surgery has generally fallen out of favor, a few research groups are still examining the Batista procedure among patients who are unsuitable for heart transplantation, such as the elderly.

Cardiomyopathy

During the Batista procedure, a small portion of the enlarged lower-left chamber (ventricle) of the heart was removed, bringing the size of the left ventricle back towards normal. While the patient was under general anesthesia and connected to a heart-lung machine, the surgeon would locate the left anterior descending coronary artery and make two small cuts down and outward to remove a wedge of the left ventricle. This was roughly similar to the way someone would cut out a piece of pie. The remaining edges of the left ventricle were then sewn together, returning the chamber to its normal size. The incision was closed, and the surgery complete.

A variation of the Batista, called the Dor procedure, involved a lengthwise incision in the left ventricle along an area damaged by a heart attack in which an aneurysm has formed. The aneurysm is stitched off, thus reducing the size of the ventricle. If the damaged area was too large, a patch was used to cover the damaged area. This variation was invented by Dr. Vincent Dor of Monaco and continues to see use.

The Batista procedure carried a number of risks. For example, if the procedure was unsuccessful, the patient might need to undergo emergency surgery immediately to have a mechanical heart implanted. In addition, the surgery was associated with a high risk of dangerous heart arrhythmias, which sometimes required implantation of an implantable cardioverter defibrillator at the same time the surgery was performed. Finally, many people who underwent the Batista procedure suffered from recurrent heart failure after the surgery. There are also a number of risks associated with any type of open-heart surgery.

History of the Batista procedure

The standard treatment for patients with advanced end stage heart failure is to take medication and wait for a donor heart. However, there is a serious shortage of donor hearts. Dr. Randas Batista saw the effects of this shortage first-hand in his native country (Brazil), where many heart failure patients were dying before a heart donor could be found. He was inspired by this experience to develop the Batista procedure as an alternative to heart transplantation. He performed this new surgery for the first time in 1983 and afterward performed it hundreds of times.

Dr. Batista’s work caught the attention of physicians at the Cleveland Clinic, which sent a group to Brazil to study the technique. According to information presented by the Cleveland Clinic at the 1997 conference of the American College of Cardiology, survival rates at six-month follow-up were similar to those associated with heart transplantation, and a significant number of patients no longer needed to be on the list for a donor heart.

However, later results were not as promising. Researchers from the Cleveland Clinic reported disappointing results with the Batista procedure in 2000. Though the conditions of 25 percent of the patients improved following the surgery, conditions rapidly deteriorated in 33 Tachycardia is an unusually fast heartbeat (more than 100 beats per minute).percent of patients. The remaining patients experienced a temporary improvement in cardiac function followed by a return to gradually declining function. The patients also experienced a high rate of abnormal heart rhythms, or arrhythmias. Because of these findings, researchers discontinued the clinical study.

About the same time, a Batista procedure study conducted by the New England Medical Center was also concluded early because of poor results. Researchers, however, credit Dr. Batista for inspiring the investigation of other strategies to reverse or correct remodeling of the left ventricle with heart failure.

Later studies, in 2005, examined the Batista procedure among elderly people (over age 65) and found that the surgery could be tolerated and may be considered among patients who were not eligible for transplantation. In this case, the risks and benefits of the Batista procedure are similar for elderly and younger people, but may represent a short-term improvement among elderly people who cannot have a heart transplant, thus altering the risk/benefit ratio in favor of the procedure. Still other researchers have examined the effectiveness of the Batista procedure combined with heart valve transplantation.

2 comments:

manu said...

Batista Operation Procedure

posted on: sat,nov 2010
posted by : manuheart123

The Batista Operation Procedure was developed by Brazilian surgeon Dr. Randas J. V. Batista, as a treatment for heart failure. Technically called as reduction left ventriculoplasty, the Batista operation is a procedure that was primarily developed for patients with dilated left ventricles and severe heart failure.

http://www.heart-consult.com/articles/210/batista-operation-procedure

Shaleh said...

halo manu, thanks for the comment, but why i cant view your blogger profile ??