A more comprehensive left ventricular repair for severely dilated cardiomyopathy

We report a patient with cardiogenic shock due to severely dilated cardiomyopathy who underwent complex, but comprehensive left ventricle (LV) repair. Preoperative investigation showed marked LV dilatation, poor LV function, severe mitral and tricuspid regurgitation, and total occlusion of two coronary arteries. We urgently performed (1) modified Batista operation which preserves the LV apex, (2) septal anterior ventricular exclusion (SAVE) operation, (3) mitral annuloplasty, (4) tricuspid annuloplasty, and (5) coronary bypass. Postoperative evaluation revealed good graft flow, reduced LV dimension preserving the elliptical shape, improved LV function, and minimal MR. Twenty-six months postoperatively, the patient has minimum clinical symptoms (NYHA: I).