| Project/Area Number |
10470281
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | National Cardiovascular Center Research Institute |
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Principal Investigator |
NAKATANI Takeshi National Cardiovascular Center Research Institute, Dept. of Surgical Research, Director (60155752)
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| Co-Investigator(Kenkyū-buntansha) |
笹子 佳門 国立循環器病センター研究所, 病院心臓外科, 医長
KOMAMURA Kazuo National Cardiovascular Center Research Institute, Dept. of Cardiovascular Dynamics, Division Head (90311448)
MIYATAKE Kunio National Cardiovascular Center Hospital, Dept. of Cardiology, Vice Director
TAKANO Hisateru National Cardiovascular Center Research Institute, 研究所, Vice Director (60028595)
KITAMURA Soichiro National Cardiovascular Center Hospital, 病院, Director (10028607)
YOSHIKADO Sasako National Cardiovascular Center Hospital, Dept. of Cardiovascular Surgery, Chief Surgeon
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| Project Period (FY) |
1998 – 2000
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| Project Status |
Completed (Fiscal Year 2000)
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| Budget Amount *help |
¥12,600,000 (Direct Cost: ¥12,600,000)
Fiscal Year 2000: ¥3,900,000 (Direct Cost: ¥3,900,000)
Fiscal Year 1999: ¥3,700,000 (Direct Cost: ¥3,700,000)
Fiscal Year 1998: ¥5,000,000 (Direct Cost: ¥5,000,000)
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| Keywords | left ventricular assist system / heart transplantation / left atrial drainage / left ventricular drainage / dilated cardiomyopathy / ischemic cardiomyopathy / recovery of natural heart / 虚血性心筋症 / 左室径 / 僧帽弁逆流 / 心筋症 / 心筋細胞径 / パーセント繊維化率 |
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| Research Abstract |
Extracorporeal National Cardiovascular Center type left ventricular assist systems (LVASs) were applied to 35 cardiomyopathy patients who were considered to be candidates for heart transplantation aged younger than 60 years old. Of those, 30 patients were suffered from dilated cardiomyopathy, 4 from ischemic cardiomyopathy and 1 for dilated phase of hypertrophic cardiomyopathy. Implantation of LVAS was performed when patient condition was deteriorated in spite of massive medical and/or surgical treatments. Five of 35 patients were needed right heart support due to profound right heart failure. In 30 cases with LVAS support without right heart support, initial 10 cases were implanted left atrial drainage type LVAS(LA). In recent cases, left ventricular drainage type LVAS(LV) were implanted. Mean assist duration was 165 days in LA type and was 367 days, including ongoing 8 cases, in LV type. All cases were stabilized after application of LVAS. Rehabilitation was started and administrations of beta-blockers and ACE inhibitors were performed. Natural cardiac function was tested by echocardiography periodically and weaning from LVAS was tried when natural heart function showed recovery of its function. In LA type, 3 out of 10 cases showed recovery of their natural heart function and LVASs were removed after 3-5 months support. All three cases are doing well 2.5-6.8 years after removal under outpatient clinic. In 20 LV type supports, only 4 cases showed recovery of natural heart. In one case, removal from LVAS was performed followed by reimplantation of LVAS due to acute deterioration of natural heart function. In seven cases (LA: 2, LV: 5), heart transplantation was done after 330 days supports on average. Their excised hearts showed severe destruction of myocardial tissue. Difference between LA type and LV type in effects of cardiac function and evaluation of natural heart function under LVAS support were studied.
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