tailieunhanh - Báo cáo y học: "Effective cardiac resynchronization therapy for an adolescent patient with dilated cardiomyopathy seven years after mitral valve replacement and septal anterior ventricular exclusio"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Effective cardiac resynchronization therapy for an adolescent patient with dilated cardiomyopathy seven years after mitral valve replacement and septal anterior ventricular exclusion. | Mima et al. Journal of Cardiothoracic Surgery 2010 5 47 http content 5 1 47 JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Effective cardiac resynchronization therapy for an adolescent patient with dilated cardiomyopathy seven years after mitral valve replacement and septal anterior ventricular exclusion Takahiro Mima 1 Shiro Baba 1 Noritaka Yokoo1 Shinji Kaichi1 Takahiro Doi2 Hiraku Doi1 and Toshio Heike1 Abstract Cardiac resynchronization therapy CRT is a new treatment for refractory heart failure. However most heart failure patients treated with CRT are middle-aged or old patients with idiopathic or ischemic dilated cardiomyopathy. We treated a 17 year 11 month old girl with dilated cardiomyopathy after mitral valve replacement MVR and septal anterior ventricular exclusion SAVE . Seven years after the SAVE procedure she presented complaining of palpitations and general fatigue with normal activity. Her echocardiogram showed reduced left ventricular function. Despite of optimal medical therapy her left ventricular function continued to decline and she experienced regular arrhythmias such as premature ventricular contractions. We thus elected to perform cardiac resynchronization therapy with defibrillator CRT-D . After CRT-D her clinical symptoms improved dramatically and left ventricular ejection fraction LVEF improved from to as assessed by echocardiogram. Serum BNP levels decreased from to pg ml. On ECG arrhythmias were remarkably reduced and QRS duration was shortened from 174 to 152 msec. In conclusion CRT-D is an effective therapeutic option for adolescent patients with refractory heart failure after left ventricular volume reduction surgery. Background Left ventricular volume reduction therapy has been an effective treatment modality for end-staged dilated cardiomyopathy. Some patients however suddenly worsen due to leading to heart failure. To address asynchrony cardiac resynchronization .