Effective cardiac resynchronization therapy for an adolescent patient with dilated cardiomyopathy seven years after mitral valve replacement and septal anterior ventricular exclusion

Autor: Takahiro Doi, Takahiro Mima, Noritaka Yokoo, Shinji Kaichi, Hiraku Doi, Toshio Heike, Shiro Baba
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Pulmonary and Respiratory Medicine
Cardiomyopathy
Dilated
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Heart Ventricles
Cardiac resynchronization therapy
lcsh:Surgery
lcsh:RD78.3-87.3
QRS complex
Ventricular Dysfunction
Left
Internal medicine
Mitral valve
Case report
Medicine
Humans
cardiovascular diseases
Cardiac Surgical Procedures
Heart Failure
Heart Valve Prosthesis Implantation
Ejection fraction
business.industry
Mitral valve replacement
Cardiac Pacing
Artificial
Dilated cardiomyopathy
Arrhythmias
Cardiac
General Medicine
lcsh:RD1-811
medicine.disease
Cardiac surgery
medicine.anatomical_structure
lcsh:Anesthesiology
Heart failure
Cardiology
cardiovascular system
Mitral Valve
Female
Surgery
business
Cardiology and Cardiovascular Medicine
circulatory and respiratory physiology
Zdroj: Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery, Vol 5, Iss 1, p 47 (2010)
ISSN: 1749-8090
Popis: 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 31.2% to 51.3% as assessed by echocardiogram. Serum BNP levels decreased from 448.2 to 213.6 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.
Databáze: OpenAIRE
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