Batista's operation with coronary artery bypass grafting and mitral valve plasty for ischemic dilated cardiomyopathy.

A 52-year-old male was admitted for angina pectoris and congestive heart failure classified as New York Heart Association class III. Coronary angiography showed 95% stenosis in the left anterior descending artery, 99% stenosis in the first diagonal branch, total occlusion in the left circumflex artery, and a hypoplastic right coronary artery. Left ventriculography showed a severely dilated left ventricle (ejection fraction 20%) and mild mitral regurgitation. In the myocardial scintigram using 99m-tetrofosmin, there was no viability in the posterolateral wall although the other wall was viable. Partial left ventriculectomy, which is called Batista's operation, coronary artery bypass grafting and Alfieri's mitral valve plasty were performed concomitantly. Postoperatively, the ejection fraction was improved to 39%, and all grafts were patent. The patient was discharged in New York Heart Association class I. We concluded that to succeed in partial left ventriculectomy for ischemic dilated cardiomyopathy, not only should there be no viability in the posterolateral wall to be resected for volume reduction, but the coronary artery which perfuses the residual myocardium with viability should be graftable.