A survey on partial left ventriculectomy in the Asia-Pacific region.

Background: There has been increasing interest in partial left ventriculectomy as a new therapy for end-stage heart failure. Because the most significant impact of this development is likely to be in regions where heart transplantation is largely unavailable, we conducted a survey among a group of cardiac surgeons based in the Asia-Pacific region to evaluate their overall views on partial left ventriculectomy procedures.
Methods: A questionnaire was sent to surgeons from 65 major institutions in 17 countries and regions in the Asia-Pacific. Questions examined current demographics and opinions regarding potential application and future prospects of this operation.
Results: Surveyed surgeons were based in equal proportions in academic, government, and private practice institutions. One third of respondents have already performed partial left ventriculectomy operations, largely in small numbers. In total, 86 procedures were performed with 75% hospital survival rate. Failures were thought to be caused by limited knowledge about patient selection criteria and lack of experience with operative technique and perioperative care. The majority of respondents believe that partial left ventriculectomy is potentially a valuable intervention and intend to perform more cases. Nevertheless, most surgeons identified the need to have larger clinical experience, to perform randomized trials against other therapeutic modalities, and to improve perioperative care.
Conclusions: Although all surgeons recognize that more knowledge is needed before partial left ventriculectomy becomes a standard procedure, it is clear from this survey that the procedure has rapidly gained interest, with more surgeons seeking to learn it.