When Less is More; May 1998; Scientific American Magazine; by Randal; 2 Page(s)

In May 1996, when a bedridden Jim Absalom of Youngstown, Ohio, had just learned that a heart transplant was his only other option, two doctors at the Cleveland Clinic made him an offer he couldn¿t refuse. Cardiologist Randall C. Starling and transplant surgeon Patrick M. McCarthy had recently been to Hospital Angelina Caron in Curitiba, Brazil, to see Randas Batista perform a revolutionary operation that could give Absalom¿s own heart a new lease on life. Afraid he would die before a donor heart became available, the 65- year-old agreed to the surgery.

Absalom¿s problem was congestive heart failure, a disorder in which the left ventricle of the heart cannot pump enough blood to the rest of the body because the ventricle has gotten too large and flabby. Batista pioneered the procedure in 1983, when he was working at a hospital where transplants were not done. It is based on the premise that making the ventricle smaller by taking a wedge out of its muscular wall will improve its efficiency.