1、LEFT VENTRICULOPLASTY FORENDSTAGE CARDIOMYOPATHY,HISAYOSHI SUMA,THE CARDIOVASCULAR INSTITUTE TOKYO,LEFT VENTRICULOPLASTY,ISCHEMIC CARDIOMYOPATHY,Definition:,Non-aneurysmal diffuse akinetic left ventricle with chronic heart failure following myocardial infarction,Diastole,Systole (EF 6%),ISCHEMIC CAR
2、DIOMYOPATHYTrias of “ Bad ” ventricle,Dilated LVIntractable heart failureNo angina pectoris,0,2,4,6,8,10,12,1.0,0.8,0.6,0.2,0.0,Years since operation,n = 57,EF 35%,CABG FOR ISCHEMIC CARDIOMYOPATHY,Shah et.al. JTCVS 2OO3; 126:1320 - 7,0.4,Estimate of Survival,50%,20%,SAVE operation,SAVE FOR DCM,Preop
3、.,Postop.,EF (%) EDVI (ml /m2 ) ESVI (ml /m2) BNP (pg/ml),27 233 171 714,39 133,81 267,SAVE FOR DCM,Preop.,Postop.,LVEDP(mmHg) PAP (mmHg),11 28/17,18 38/15,LEFT VENTRICULOPLASTY FOR ISCHEMIC CARDIOMYOPATHY,- HAYAMA HEART CENTER -,VENTRICULOPLASTY FOR IDIOPATHIC DCM - Actuarial Survival Curve -,100,9
4、0,80,70,60,50,40,10,0,30,20,1,2,3,4,5,6,7,Survival Rate,(%),Postoperative Years,66.4,53.5,44.7,41.3,n = 96,VENTRICULOPASTY FOR DCM,0,1,2,3,4,5,100,(%),Survival Rate,Postoperative Years,50,LVP No inotropes,LVP Preop. inotropes,LVAS REMATCH,Medical Treatment,55,60,78,20,10,43,74,34,59,LEFT VENTRICULOP
5、LASTY FOR IDIOPATHIC DCM,(%),40,30,20,10,0,Preop.,Preop. 1 mo.,1 yr,2 yrs,3 yrs,n 80 74 28 20 9,19.8,30.1,31.8,30.2,28.3,(mmHg),30,20,10,0,Preop.,Preop. 1 mo.,1 yr,2 yrs,3 yrs,n 37 31 19 6,26,22,22,18,EF,LVEDP,LEFT VENTRICULOPLASTY FOR IDIOPATHIC DCM,(l/min/m2),(pg/ml),1000,500,0,Preop.,Preop. 1 mo.,1 yr,2 yrs,3 yrs,898,629,413,229,4,3,2,1,0,Preop.,Preop. 1 mo.,1 yr,2 yrs,3 yrs,n 35 33 23 18 6,2.3,3.3,2.8,2.8,2.7,362,CI,BNP,n 41 33 23 15 7,LVAD,LV Plasty,HTX,Ongoing shock,Valve,Repair,Small LV,RV CM,
