Dr. Randas Batista (Batista Operation)

The Batista Operation - What is it ?

The Batista Operation is technically called a REDUCTION LEFT VENTRICULOPLASTY. It is an open-heart operation performed with the aid of a heart lung machine to maintain circulation while the heart is stopped. The essence of the procedure is to remove a wedge of left ventricle muscle (weighing about 40 to as much as 250 grams) and stitch together the two edges of the ventricle. In this manner the size of the left ventricle is reduced, and the ventricle is remodelled as well.

In addition, sometimes, the mitral valve (which lies between the left ventricle and left atrium) may need to be removed and replaced with an artificial valve. In patients who have heart rhythm disturbances as well, an artificial implantable defibrillator device may be implanted. If the coronary arteries are diseased, they may be grafted too (CABG 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.

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.