Posterior Restoration of Left Ventricle and Mitral Valve Repair in Patients With Muscular Dystrophy Masanori Hirota, MD, PhD, Joji Hoshino, MD, Yasuhisa.

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Presentation transcript:

Posterior Restoration of Left Ventricle and Mitral Valve Repair in Patients With Muscular Dystrophy Masanori Hirota, MD, PhD, Joji Hoshino, MD, Yasuhisa Fukada, MD, Taichi Kondo, MD, Yu Takahashi, MD, Yuichi Notomi, MD, Tadashi Isomura, MD, PhD The Annals of Thoracic Surgery Volume 97, Issue 2, Pages 577-581 (February 2014) DOI: 10.1016/j.athoracsur.2013.09.030 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative and postoperative two-dimensional echocardiography findings. (A) long-axis view shows severe functional mitral regurgitation (MR) caused by tethering secondary to dilated left ventricular (LV) chamber. (B) The LV dimension decreased by posterior restoration procedure and mitral valve repair has alleviated MR (on the 9th postoperative day). The Annals of Thoracic Surgery 2014 97, 577-581DOI: (10.1016/j.athoracsur.2013.09.030) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Speckle-tracking echocardiography findings. (A) Preoperative short-axis view shows dyskinetic area (blue) on postero-lateral LV wall between both papillary muscles. (B) Dyskinetic area has been surgically excluded by the posterior restoration procedure, which reduced LV volume with better mechanical synchronization (on the 9th postoperative day). The Annals of Thoracic Surgery 2014 97, 577-581DOI: (10.1016/j.athoracsur.2013.09.030) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Representative macroscopic and microscopic findings. (A) Intraoperative image shows fibrotic scar on epicardial surface of postero-lateral LV wall. (B) Surgical specimen shows fatty infiltration and cardiomyocytes replaced by connective tissue (hematoxylin and eosin stain; magnification 40×, approximately). (C) Some cardiomyocytes have hypertrophic cytoplasm with large, hyperchromatic nuclei (hematoxylin and eosin stain; magnification 400×, approximately). The Annals of Thoracic Surgery 2014 97, 577-581DOI: (10.1016/j.athoracsur.2013.09.030) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions