缺血性和非缺血性心肌病的外科治疗PPT.pptVIP

　Non-transplant surgical treatment for ischemic and non-ischemic cardiomyopathy;Operation for DCM (Dilated cardiomyopathy);Dyskinesis=LV aneurysm;Dor. V; Current Opinion in Cardiology 1997, 12: 534;DCM,noMR Preop LVG;;Ischemic/Non-ischemic;Operative procedures for DCM Left Ventricular Restoration (LVR) EVCPP (Dor), SAVE, PLV (Batista) Mitral Valve Surgery CABG CRT-D, Cryoablation ………;①EVCPP（Dor), ②SAVE、③PLV(Batista);Indication for SAVE;SAVE（Septal anterior Ventricular Exclusion with large patch）;EVCPP (Dor);Surgical procedures for Non-ischemic DCM;;Prognosis of CHF of Stage C;Circulation 2007;115:1563-1570 Prevalence of CHF in the Community--- Ammar KA et al.;;;CRT-OFF;CRT-ON;Batista operation (PLV)?;Modified Batista Operation Indication=Posterolateral akinesis with speckle tracking echo 1. Partial left ventriculectomy at the posterior wall between bilateral papillary muscle (Volume reduction) 2. Papillary muscle plication (Preservation of papillary muscle-mitral valve continuity） 3.Cryoablation at the cut edge and mitral annulus (Prevention of macro-reentry);Mid-SAX; Circumferential strain;;Mitral surgery for Functional MR?;Intra-operative volume test for MR;Presence of MR;Surgical treatment for ischemic MR;LV dilatation;Two undersized ring annuloplasty =Improve annular dilatationPapillary muscle plication =Improve mitral tethering ;;Dilated cardiomyopathy Papillary muscle plication;＜Degree＞;In non-ischemic DCM preoperative status was more severe than that of ischemic DCM and the late results showed better in ischemic DCM than those in non-ischemic DCM. However, aggressive non-transplant surgical treatment with LVR or valve surgery can be useful for indicated patients with both ischemic and non-ischemic DCM. ;Surgical treatment for ischemic or non-ischemic dilated cardiomyopathy (DCM) is a challenging treatment. The development of the procedures does improve the operative and long-follow-up results.