Related Experiment Videos
[Treatment of dilated cardiomyopathy in childhood]
R Radley-Smith1, Z Slavík, J Spatenka
1Harefield Hospital, Middlesex a National Heart-Lung Institute, Londýn, Velká Británie.
Insights
Heart transplantation offers improved survival for children with dilated cardiomyopathy. Early transplantation is recommended for severe cases unresponsive to conservative treatment, showing an 81% 4-year survival rate.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Transplantation Medicine
Context:
- Dilated cardiomyopathy in children presents significant challenges with poor conservative treatment outcomes.
- Heart transplantation is a critical intervention for end-stage pediatric heart failure.
Purpose:
- To review the etiology, pathophysiology, and diagnostic criteria of dilated cardiomyopathy.
- To evaluate the outcomes of heart transplantation in pediatric patients with dilated cardiomyopathy.
Summary:
- A review of available literature on dilated cardiomyopathy was conducted.
- Between 1984 and 1991, 67 children underwent heart or heart-lung transplantation for cardiomyopathy at Harefield Hospital.
- Forty-seven of these patients had dilated cardiomyopathy, with a mean age of 6.5 years. The 4-year actuarial survival rate was 81%.
Impact:
- Heart transplantation demonstrates reasonable progress in treating severe acquired pediatric dilated cardiomyopathy.
- Early transplantation is now recommended for children with dilated cardiomyopathy and a low left ventricular shortening fraction (<0.13) unresponsive to conservative therapy, or with familial traits or severe fibrosis.
Abstract:
Authors reviewed available information concerning etiology and pathophysiology of dilated cardiomyopathy. Diagnostic criteria and current poor results of conservative treatment are discussed. Between August 1984 and August 1991 67 children with various types of cardiomyopathy underwent heart and heart and lung transplantation at Harefield Hospital, U.K. Dilated cardiomyopathy was the indication for transplantation in 47 patients (mean age at operation was 6.5 years, range 0.3-4.8 years). Eighty-one percent actuarial survival at 4 years after operation represents reasonable progress in the treatment of this severe acquired disease. Currently, early transplantation is recommended in children with dilated cardiomyopathy and with low shortening fraction of left ventricle (below 0.13), without any improvement after 3 months of conservative treatment, will familial trait of dilated cardiomyopathy and/or with severe myocardial fibrosis.