虚血性心筋症に対し左室形成術を施行した2症例─中規模病院における重症心不全治療の取り組み
虚血性心筋症(ischemic heart cardiomyopathy: ICM)では重症例が多く，個々の症例により選択されうる術式，方法が様々であり，術前，術後管理に対する入念な検討が必要であるが，心拡大が著明なICM症例に対して，左室形成術は有効な術式と思われる．当院のようなスタッフの少ない地方の中規模病院で重症心不全治療を安全に行うためには，大学病院，センター病院など植込み型補助人工心臓(ventricular assist device: VAD)や移植医療を含めた心不全治療を積極的に行う施設と連携をとりながら診療を行う必要がある．虚血性心筋症に対し左室形成術(left ventri...
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| Published in | 日本冠疾患学会雑誌 Vol. 20; no. 2; pp. 122 - 125 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本冠疾患学会
2014
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1341-7703 2187-1949 |
| DOI | 10.7793/jcoron.20.13-00010 |
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| Abstract | 虚血性心筋症(ischemic heart cardiomyopathy: ICM)では重症例が多く，個々の症例により選択されうる術式，方法が様々であり，術前，術後管理に対する入念な検討が必要であるが，心拡大が著明なICM症例に対して，左室形成術は有効な術式と思われる．当院のようなスタッフの少ない地方の中規模病院で重症心不全治療を安全に行うためには，大学病院，センター病院など植込み型補助人工心臓(ventricular assist device: VAD)や移植医療を含めた心不全治療を積極的に行う施設と連携をとりながら診療を行う必要がある．虚血性心筋症に対し左室形成術(left ventricular restoration: LVR)を施行した2例の症例報告とともに，当院における重症心不全症例に対する取り組みについて口述する． |
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| AbstractList | 虚血性心筋症(ischemic heart cardiomyopathy: ICM)では重症例が多く，個々の症例により選択されうる術式，方法が様々であり，術前，術後管理に対する入念な検討が必要であるが，心拡大が著明なICM症例に対して，左室形成術は有効な術式と思われる．当院のようなスタッフの少ない地方の中規模病院で重症心不全治療を安全に行うためには，大学病院，センター病院など植込み型補助人工心臓(ventricular assist device: VAD)や移植医療を含めた心不全治療を積極的に行う施設と連携をとりながら診療を行う必要がある．虚血性心筋症に対し左室形成術(left ventricular restoration: LVR)を施行した2例の症例報告とともに，当院における重症心不全症例に対する取り組みについて口述する． |
| Author | 中桐, 啓太郎 向原, 伸彦 北村, アキ |
| Author_xml | – sequence: 1 fullname: 北村, アキ organization: 赤穂市民病院心臓血管外科 – sequence: 1 fullname: 中桐, 啓太郎 organization: 赤穂市民病院心臓血管外科 – sequence: 1 fullname: 向原, 伸彦 organization: 兵庫県立姫路循環器病センター心臓血管外科 |
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| Copyright | 2014 日本冠疾患学会 |
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| References | 6)Buckberg GD, Athanasuleas CL: The STICH trial: misguided conclusions. J Thorac Cardiovasc Surg 2009; 138: 1060-1064 5)Jones RH, Velazquez EJ, Michler RE, et al: Coronary bypass surgery with or without surgical ventricular reconstruction. N Engl J Med 2009; 360: 1705-1717 4)Kron IL, Green GR, Cope JT: Surgical relocation of the posterior papillary muscle in chronic ischemic mitral regurgitation. Ann Thorac Surg 2002; 74: 600-601 3)Otsuji Y, Kumanohoso T, Yoshifuku S, et al: Isolated annular dilation does not usually cause important functional mitral regurgitation: comparison between patients with lone atrial fibrillation and those with idiopathic or ischemic cardiomyopathy. J Am Coll Cardiol 2002; 39: 1651-1656 8)Trochu JN, Leprince P, Bielefeld-Gomez M, et al: Left ventricle assist device: when and which patients should we refer? Arch Cardiovasc Dis 2012; 105: 114-121 2)Messas E, Guerrero JL, Handschumacher MD, et al: Chordal cutting: a new therapeutic approach for ischemic mitral regurgitation. Circulation 2001; 104: 1958-1963 1)Harris KM, Sundt TM 3rd, Aeppli D, et al: Can late survival of patients with moderate ischemic mitral regurgitation be impacted by intervention on the valve? Ann Thorac Surg 2002; 74: 1468-1475 7)Isomura T, Hoshino J, Fukada Y: Volume reduction rate by surgical ventricular restoration determines late outcome in ischaemic cardiomyopathy. Eur J Heart Fail 2011; 13: 423-431 |
| References_xml | – reference: 3)Otsuji Y, Kumanohoso T, Yoshifuku S, et al: Isolated annular dilation does not usually cause important functional mitral regurgitation: comparison between patients with lone atrial fibrillation and those with idiopathic or ischemic cardiomyopathy. J Am Coll Cardiol 2002; 39: 1651-1656 – reference: 6)Buckberg GD, Athanasuleas CL: The STICH trial: misguided conclusions. J Thorac Cardiovasc Surg 2009; 138: 1060-1064 – reference: 7)Isomura T, Hoshino J, Fukada Y: Volume reduction rate by surgical ventricular restoration determines late outcome in ischaemic cardiomyopathy. Eur J Heart Fail 2011; 13: 423-431 – reference: 4)Kron IL, Green GR, Cope JT: Surgical relocation of the posterior papillary muscle in chronic ischemic mitral regurgitation. Ann Thorac Surg 2002; 74: 600-601 – reference: 1)Harris KM, Sundt TM 3rd, Aeppli D, et al: Can late survival of patients with moderate ischemic mitral regurgitation be impacted by intervention on the valve? Ann Thorac Surg 2002; 74: 1468-1475 – reference: 5)Jones RH, Velazquez EJ, Michler RE, et al: Coronary bypass surgery with or without surgical ventricular reconstruction. N Engl J Med 2009; 360: 1705-1717 – reference: 8)Trochu JN, Leprince P, Bielefeld-Gomez M, et al: Left ventricle assist device: when and which patients should we refer? Arch Cardiovasc Dis 2012; 105: 114-121 – reference: 2)Messas E, Guerrero JL, Handschumacher MD, et al: Chordal cutting: a new therapeutic approach for ischemic mitral regurgitation. Circulation 2001; 104: 1958-1963 |
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| SubjectTerms | ischemic cardiomyopathy left ventricular restoration medical cooperation severe heart failure treatment |
| Title | 虚血性心筋症に対し左室形成術を施行した2症例─中規模病院における重症心不全治療の取り組み |
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