PMID- 23985398
OWN - NLM
STAT- MEDLINE
DCOM- 20131017
LR  - 20130829
IS  - 0021-5252 (Print)
IS  - 0021-5252 (Linking)
VI  - 66
IP  - 1
DP  - 2013 Jan
TI  - [Effectiveness of simultaneous cardiac resynchronization therapy in surgical 
      valvular patients with severe heart failure].
PG  - 4-10
AB  - BACKGROUND: Cardiac resynchronization therapy (CRT)has been accepted broadly as 
      an alternative to medical treatment in managing severe heart failure patients. 
      Despite advance in CRT, the presence of a significant valvular heart disease was 
      currently specific exclusion criteria and a response to this therapy remains 
      unclear. The purpose of this study was to determine the effectiveness of CRT in 
      heart failure patients undergoing valvular operation simultaneously. PATIENTS AND 
      METHODS: Between July 2010 and May 2012, 8 heart failure patients who underwent 
      CRT in conjunction with valvular surgery were experienced. Right and left 
      ventricular and atrial epicardial leads were implanted after completion of 
      valvular procedures. In patients with chronic atrial fibrillation(Af),maze 
      procedure was performed in order to eliminate Af. To evaluate the improvement of 
      ventricular mechanical dyssynchrony, the echocardiographic assessment was 
      repeated on admission and 1 month after the CRT implantation. RESULTS: There was 
      no operative death. One patient of ischemic cardiomyopathy died of sustained 
      ventricular tachycardia 2 months after the operation. Postoperative course of 
      severe heart failure patients was uneventful and all patients except 1 discharged 
      on foot with improved New York Heart Association (NYHA) class. Echocardiographic 
      parameters of dyssynchrony did not reach to statistical significance, but several 
      parameters, left ventricular( LV)-pre-ejectionperiod( PEP) and interventricular 
      mechanical delay (IVMD) showing time delay of cardiac contraction, tended to be 
      improve, suggesting contribution to satisfactory postoperative course. 
      CONCLUSION: The acceptable outcome was demonstrated with our concept to recover 
      the intraventricular and atrioventricular synchrony. Although it might be 
      difficult to establish the patient selection criteria for concomitant CRT and 
      valvular surgery, our strategy is considered to be a feasible procedure to 
      improve the morbidity and mortality in patients with severe heart failure due to 
      valvular disease.
FAU - Uchida, Tetsuro
AU  - Uchida T
AD  - Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, 
      Japan.
FAU - Mizumoto, Masahiro
AU  - Mizumoto M
FAU - Kim, Cholsu
AU  - Kim C
FAU - Maekawa, Yoshiyuki
AU  - Maekawa Y
FAU - Miyazaki, Ryota
AU  - Miyazaki R
FAU - Hirooka, Shuto
AU  - Hirooka S
FAU - Yasumoto, Takumi
AU  - Yasumoto T
FAU - Yoshimura, Yukihiro
AU  - Yoshimura Y
FAU - Sadahiro, Mitsuaki
AU  - Sadahiro M
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Kyobu Geka
JT  - Kyobu geka. The Japanese journal of thoracic surgery
JID - 0413533
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cardiac Resynchronization Therapy
MH  - Female
MH  - Heart Failure/etiology/*therapy
MH  - Heart Valve Diseases/complications/*surgery
MH  - Humans
MH  - Male
EDAT- 2013/08/30 06:00
MHDA- 2013/10/18 06:00
CRDT- 2013/08/30 06:00
PHST- 2013/08/30 06:00 [entrez]
PHST- 2013/08/30 06:00 [pubmed]
PHST- 2013/10/18 06:00 [medline]
PST - ppublish
SO  - Kyobu Geka. 2013 Jan;66(1):4-10.