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Surgical Options for Refractory Heart Failure Patients with Non-ischemic Dilated Cardiomyopathy Yasushige Shingu 1 , Tomonori Ooka 1 , Tsuyoshi Tachibana 1 , Suguru Kubota 1 , Yoshiro Matsui 1 1Department of Cardiovascular and Thoracic Surgery, Hokkaido University Keyword: non-ischemic dilated cardiomyopathy , left ventriculoplasty , slope in the preload recruitable stroke work relationship pp.484-487
Published Date 2018/7/1
DOI https://doi.org/10.15106/j_kyobu71_484
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Surgical strategy for non-ischemic dilated cardiomyopathy (NIDCM) is currently controversial. Subjects were 20 patients who underwent left ventriculoplasty (LVP) from 2006 to 2013 and 6 patients who underwent papillary muscle tugging approximation (PMTA) after 2015. PMTA is a new trans-mitral approach combined with valve replacement without left ventriculotomy. Another group of patients (n=14)who were registered for heart transplantation (HTx) after 2013 was also analyzed for left ventricular assist device (LVAD) free survival. Mw (slope in the preload recruitable stroke work relationship) calculated by single beat technique using echocardiography was employed as a load-independent cardiac functional parameter. The baseline characteristics and Mw were not different between the LVP and PMTA groups. One-year survival was significantly lower in the LVP group(53%)than in the PMTA group(100%)[log-rank:p=0.024]. In the HTx group, early LVAD implantation was necessary in the patients who had low Mw(<20)at the time of registration. In conclusion, PMTA would be one option for NIDCM patients (non-HTx candidates) with severe mitral regurgitation. Early LVAD implantation might be predicted in HTx candidates with low Mw(<20).


© Nankodo Co., Ltd., 2018

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電子版ISSN 2432-9436 印刷版ISSN 0021-5252 南江堂

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