The Batista procedure (also called a reduction left ventriculoplasty) was an experimental heart

procedure that proposed the reversal of the effects of remodeling in cases of end-stage dilated
cardiomyopathy refractory to conventional medical therapy. The hypothesis of the operation
appears to be that reduction (resection) of marginally viable ventricular mass may result in
superior geometric remodeling thus conferring better performance when faced with ventricular
failure. In spite of promising initial results, the method was soon found to be of little if any benefit,
and it is no longer considered a recommended treatment for the disease.
The Batista procedure was invented by Brazilian physician and cardiac surgeon Randas
Batista in 1994 for use in patients with non-ischemic dilated cardiomyopathy. Many of his
patients were victims of Chagas' Disease. Chagas' disease represents a parasitic nonischemic
cardiomyopathy targeting parasympathetic inflow to the heart. Chagas' Cardiomyopathy thus
represents a unique method of study of diastolic heart failure. It may be addressed by removal of
a portion of viable tissue from the left ventricle to reduce its size (partial left ventriculectomy), with
or without repair or replacement of the mitral valve. [1]
Although several studies showed benefits from this surgery, studies at the Cleveland
Clinic concluded that this procedure was associated with a high early and late failure rate. At 3
years only 26 percent were event-free and survival rate was only 60 percent. [2] Most hospitals in
the US have abandoned this operation and it is no longer included in heart failure guidelines. [3]
According to this article, likely to be written in 2002, [4] there is a modified Batista surgery done in
Japan that has reported higher survival rate. An excerpt is show below.
"Hisayoshi Suma and his colleagues at the Hayama Heart Center have performed left
ventriculoplasty in 238 patients over the last 5 years, including 138 patients with left ventricular
(LV) dysfunction caused by coronary artery disease (CAD) and 100 patients with non-ischemic
cardiomyopathy, mostly idiopathic dilated cardiomyopathy...
...expanding on patient selection, when the Batista operation was applied without any selection
criteria, the in-hospital mortality rate was 43%, but this decreased to 15% with the use of site
selection and intraoperative echo evaluation, which helps guide the choice of procedure. In the
most recent 47 patients undergoing elective surgery, the hospital mortality was only 6.4%. "