Surgical approach to dilated cardiomyopathy

  1, heart transplantation: started in 1968, 1-year survival rate of 83% after surgery, 5-year survival rate of more than 70%. Due to economic constraints, the lack of donors, the complexity of surgical manipulation, and rejection reactions and other unfavorable causes, though.  2, myocardioplasty: myocardioplasty or power myocardioplasty began in 1985, the survival rate of 83% at 1 year after surgery.  3, partial left ventricular myocardial resection: partial left ventricular myocardial resection (ventricular decompression) or into Batista procedure began in 1994, with a 1-year survival rate of 63-82%. The basic method is to remove 75-150g of myocardium in the left ventricular sidewall in a wedge shape and then suture the ventricular wall, which reduces the ventricular volume, decreases the ventricular wall tension, progresses the myocardial contraction and increases the heart beat volume.  4, mitral valvuloplasty: mitral valvuloplasty began in 1994, 1-year survival rate of 75% after surgery. The method is to reduce the diameter of the mitral valve orifice and preserve the mitral valve anatomy (leaflets, tendons and papillary muscles). This restores the normal geometry of the left neoform, increases the ejection fraction, and improves cardiac function. Other patients undergo “double orifice cardioplasty,” in which mitral valvuloplasty is performed along with tricuspid valvuloplasty to improve cardiac function. According to the literature, this procedure is still under trial because the effect is not confirmed.  5. Left ventricular assist device: This procedure involves placing the two ends of an extracorporeal pump device on the apical part of the left ventricular cavity and on the aorta, respectively. This assist device is mainly used for patients with advanced dilated cardiomyopathy while waiting for a cardiac donor. Individual patients were withdrawn from the left ventricular assist device after 6 months of application of the device, when the left ventricle shrank and cardiac function improved. This assist device is relatively crude and is the prototype of the artificial heart.  6. Artificial heart: This method is based on a reduced size of the left ventricular assist device, which is placed under the skin of the abdomen or inside the breast cavity in patients with dilated cardiomyopathy.