缺血性和非缺血性心肌病的外科治疗.pptVIP

LV dilatation Ischemia LV EDP Two undersized ring annuloplasty =Improve annular dilatationPapillary muscle plication =Improve mitral tethering Mitral Valve Plasty Mitral Annuloplasty Using Undersized Circumferential Ring Dilated cardiomyopathy Papillary muscle plication ＜Degree＞ Control (n=5) 108±11° DCM with Papillary muscle plication (n=12) Before op 118±10° After op 106±8° ＜Distance＞ Control(n=5) 4.4±0.5cm DCM with Papillary muscle plication (n=12) Before op 7.8±0.8cm After op 6.3±0.9cm In non-ischemic DCM preoperative status was more severe than that of ischemic DCM and the late results showed better in ischemic DCM than those in non-ischemic DCM. However, aggressive non-transplant surgical treatment with LVR or valve surgery can be useful for indicated patients with both ischemic and non-ischemic DCM. Conclusion2-1 Surgical treatment for ischemic or non-ischemic dilated cardiomyopathy (DCM) is a challenging treatment. The development of the procedures does improve the operative and long-follow-up results. Conclusion2-2 * Fig 1 and 2 are showing regional heterogeneity of circumferential strain in the LV wall before SVR; PLV: Fig 1 and SAVE (Dor): Fig 2. Passive stretching at end-systole were demonstrated in the posterior wall of the before-PLV ventricles (Fig1) and in the septum of the before-SAVE ventricles (Fig 2). Speckle tracking ultrasound imaging could express LV wall contractility (which in turn the viability), which enables us to make strategy before SVR. (if patients give us good echo-window…) * 第26回日本外科系連合学会学術集会 * 第26回日本外科系連合学会学術集会 * HAYAMA HEART CENTER 　Non-transplant surgical treatment for ischemic and non-ischemic cardiomyopathy Hayama Heart Center Tadashi Isomura, Jyoji Hoshino, Yasuhisa Fukada, Shintaro Katahira　 Operation for DCM (Dilated cardiomyopathy) Surgical treatment for ischemic or non-ischemic dilated cardiomyopathy (DCM) is a challenging treatment. Left ventricular restoration (LVR) or valve surgery with other agg