2002 Fiscal Year Final Research Report Summary
Evaluation of Cardiac Function of Left Ventricule Remodeling Surgery for Dilated Cardiomyopathy
| Project/Area Number |
11671338
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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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 | Jichi Medical School |
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Principal Investigator |
MISAWA Yoshio Jichi Medical School, Dep.of Surgery, Assoc.Prof., 医学部, 助教授 (90209742)
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| Co-Investigator(Kenkyū-buntansha) |
KONISHI Hiroaki Jichi Medical School, Dep.of Surgery, Lecturer, 医学部, 講師 (00281741)
SAITO Tsutomu Jichi Medical School, Dep.of Surgery, Lecturer, 医学部, 講師 (40245048)
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| Project Period (FY) |
1999 – 2002
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| Keywords | left ventricular remodeling / dynamic cardiomyoplasty / adynamic cardiomyoplasty / Batiste operation / Dor operation / infarction exclusion method / left ventricular over-loading / aortic valve regurgitation |
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| Research Abstract |
Experimental studies using dogs have not yet reached their final stages, because each dog needs 6 months at least for observation after surgery. We need additional studies to get definite conclusions. However, we have now preliminary results showing that skeletal muscle grafts wrapped around the heart tend to get fatigue resistance after several months.
In clinical studies, we have revealed that mitral valve plasty is preferable to mitral valve replacement on the point of post-operative remodeling of the left ventricle in patients with degenerative mitral valve regurgitation, and that patients undergoing aortic valve replacement with stentless prosthetic valve can regain left ventricular remodeling in the early post-operative phase. As our other experiences, we have discussed intractable issues of myocardial infarction occurring after Batista operation in an international journal, and we have reported initial clinical results of maze procedure in consecutive 12 patients undergoing concomitant mitral valve surgery, showing that electro-physiological remodeling was obtained in 11 patients in the early post-operative phase up to 17 months.
Through Correspondence at Letters to the Editor in international scientific journals, we have been discussing mechanisms of hemodynamic assists after cardiomyoplasty. During the term of this project, our subjects includes the girdling effect and sparing effect, which are recognized even in adynamic cardiomyoplasty and the reduction of myocardial oxygen consumption after dynamic cardiomyoplasty. In addition, we insist on serial assessment is inevitable when left ventricular remodeling is evaluated after valve replacement in patients with aortic regurgitation. We have already reported that serial assessment alone can lead reliable results over issues of left ventricular remodeling in patients with left ventricular volume over-loading valve diseases.
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