| Simultaneous Cardiac Resynchronization
Therapy and Cardiac Surgery in a Patient with Triple Coronary
Vessel Disease, Mitral and Tricuspid Valve Insufficiency after
Three-Area Old Myocardial Infarction |
(Department of Cardiovascular Surgery, Ayase Heart
Hospital, Tokyo, Japan)
| Takashi Miura |
Imun Tei |
Takashi Oshitomi |
| Kazuki Sato |
Eiichi Tei |
|
|
We performed cardiac resynchronization
therapy (CRT) in addition to coronary artery bypass grafting
(CABG), mitral valve replacement (MVR) and tricuspid valve annuloplasty
(TAP) in a 72-year-old patient with poor cardiac function (New
York Heart Association functional class III, ejection fraction
38%), triple coronary vessel disease, and mitral and tricuspid
valve insufficiency after three-area old myocardial infarction.
Electrocardiography showed no change in the QRS interval after
CRT. However, tissue Doppler echocardiography showed synchronicity
of the septum and posterior segments in the left ventricle, and
that contraction of the septum was in the systolic phase of the
cardiac cycle after CRT. New York Heart Association functional
class improved from III to I after the operation. CRT of the
dyssynchronized myocardium in which ischemia and volume overload
were improved by CABG, MVR and TAP may improve regional cardiac
function and synchronicity.
Jpn. J. Cardiovasc. Surg. 34: 220-224 (2005) |
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