Partial Left Ventriculectomy for the Treatment of End-Stage Congestive Heart Failure and Dilated Cardiomyopathy
DESCRIPTION
Partial left ventriculectomy (PLV) is a surgical procedure aimed at improving the hemodynamic status of patients with end-stage congestive heart failure (CHF) by directly reducing left ventricular size. This surgical approach to the treatment of CHF (also known as the Batista procedure, cardio-reduction, or left ventricular remodeling surgery) is primarily directed at patients with an underlying dilated cardiomyopathy awaiting cardiac transplantation. PLV has been investigated as either a “bridge” to transplantation or as an alternative to transplantation.
POLICY
Partial left ventriculectomy for the treatment of end-stage congestive heart failure and dilated cardiomyopathy is considered investigational.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
No controlled studies were found in the published literature that validate the application of partial left ventriculectomy for the treatment of end stage congestive heart failure and dilated cardiomyopathy or provide comparisons to other treatments to show that this technology improves health outcomes.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (4:2004). Partial left ventriculectomy (7.01.66). Retrieved July 12, 2010 from BlueWeb. (5 articles and/ or guidelines reviewed)
Complete Guide to Medicare Coverage Issues [Computer software]. (2010, April). Partial ventriculectomy (also known as ventricular reduction, ventricular remodeling, or heart volume reduction surgery) - Not covered (NCD 20.26, p. 2-27). Ingenix.
Kubota, S., & Matsui, Y. (2009). Partial left ventriculectomy for end-stage dilated cardiomyopathy in small children. Circulation Journal, 73 (6), 1010-1011.
National Guideline Clearinghouse. (2005, August). ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Writing Committee to update the 2001 Guidelines for the Evaluation and Management of Heart Failure). Retrieved July 12, 2010 from http://www.guidelines.gov.
National Institute for Health and Clinical Excellence (NICE). (2004, February). Partial left ventriculectomy (the Batista procedure). Retrieved July 12, 2010 from http://www.nice.org.uk/nicemedia/live/11050/30748/30748.pdf.
Shin, M. S., Ahn, T. H., Kim, O. R., Chung, W. J., Kang, W. C., Lee, K. H., et al. (2010). Real-time 3-dimensional echocardiography of the heart 13 years after partial left ventriculectomy. Korean Circulation Journal, 40 (6), 295-298.
Sugivama, H., Hoshiai, M., Naitoh, A., Kadono, T., Suzuki, S., & Sugita, K. (2009). Outcome of non-transplant surgical strategy for end-stage dilated cardiomyopathy in young children. Circulation Journal, 73 (6), 1045-1048.
Suma, H., Tanabe, H., Uejima, T., Suzuki, S., Horii, T., and Isomura, T. (2007). Selected ventriculoplasty for idiopathic dilated cardiomyopathy with advanced congestive heart failure: Midterm results and risk analysis. European Journal of Cardiothoracic Surgery, 32 (6), 912-916.
ORIGINAL EFFECTIVE DATE: 8/1998
MOST RECENT REVIEW DATE: 8/12/2010
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