Outcome of Non-Transplant Surgical Strategy for End-Stage Dilated Cardiomyopathy in Young Children

Abstract

Background:The shortage of heart transplantation donors is a problem, but partial left ventriculectomy (PLV) and mitral valve replacement (MVR) are feasible at the optimal timing, even in young children. Methods and Results: From May 1998 to May 2008, 11 children under the age of 3 years were diagnosed with severe dilated cardiomyopathy (DCM). Indications and outcomes of non-transplant surgical strategies were evaluated and 8 procedures were performed in 6 children: 5 PLV and 3 MVR. Two of them underwent MVR after PLV because of deterioration of mitral regurgitation (MR). Age at surgery ranged from 8 months to 2 years 11 months. Four are alive, of whom 1 eventually underwent a heart transplant overseas. Two children died during the study period: 1 who underwent only MVR died of intracranial bleeding during thrombolytic therapy for a thrombus stack valve and the other child died of congestive heart failure because of progressive MR 2 months after PLV. Follow-up after PLV ranged from 2 months to 8 years, and after MVR ranged from 1 month to 4 years. Conclusions: PLV and MVR are feasible and effective and should be considered when heart failure resists conventional therapy. (Circ J 2009; 73: 1045 -1048

On Patients Who Purchase Organ Transplants Abroad

“…Patients also traveled for liver transplants . Eleven patients traveled for heart transplants . One person traveled for a lung transplant .…”

Mitral Valve Surgery for Severe Mitral Regurgitation and Dilated Cardiomyopathy-A Bridge to Transplant: Case Report and a Review of Literature

“…Nontransplant surgical therapies of end‐stage cardiomyopathy are rapidly evolving and include MVR, MV repair, and partial left ventriculectomy (PLV). We performed a literature review of non‐transplant surgeries for DCM in children 2,5–17 . A total of 33 children in the literature underwent MVR, MV repair, and/or PLV at a median age of 26 months (range 3 days–10.9 years) and a median weight of 7 kg (range 3.3–12 kg) (Table 1).…”

“…We performed a literature review of nontransplant surgeries for DCM in children. 2,[5][6][7][8][9][10][11][12][13][14][15][16][17] A total of 33 children in the literature underwent MVR, MV repair, and/or PLV at a median age of 26 months (range 3 days-10.9 years) and a median weight of 7 kg (range 3.3-12 kg) ( Table 1). Sixteen children underwent MV repair, seven underwent PLV and MV repair, five underwent PLV, and five underwent MVR.…”

Cardiomyopathy in the pediatric patients

“…Cardiac resynchronization therapy using a biventricular pacemaker has been shown to have early favorable results in children with dilated cardiomyopathy. 58 Cardiac resynchronization therapy with atrioventricular synchronous biventricular pacing has been successful in some children with dilated cardiomyopathy and left bundle branch block. Optimization of resynchronization for children with dilated cardiomyopathy is still in the early stages.…”