Dilated cardiomyopathy: an anaesthetic challenge

Anaesthesia Application for Cardiac Denervation in a Patient with Long QT Syndrome and Cardiomyopathy

Long QT syndrome is a congenital disorder that is characterized by a prolongation of the QT interval on electrocardiograms and a propensity to ventricular tachyarrhythmias, which may lead to syncope, cardiac arrest or sudden death. Cardiomyopathy and pulmonary hypertension diseases have additional risks in anaesthesia management. In this study, we emphasize on one lung ventilation, pacemaker-implantable cardioverter-defibrillator and the anaesthesia management process in a patient with long QT syndrome, cardiomyopathy and pulmonary hypertension who underwent thoracic sympathectomy.

Anesthetic management of hysterosalpingooophorectomy in a case with severe idiopathic dilated cardiomyopathy

Idiopathic dilated cardiomyopathy is a primary myocardial disease with unknown aetiology. This disease follows a prospective course that is characterized by ventricular dilation and impaired myocardial dilation. Congestive heart failure and malignant arrhythmias are the most widespread complications. The incidence of idiopathic dilated cardiomyopathy in the general population is 5-8/100.000. Because of the increased risks of perioperative complications, anesthetic management of this disease requires the application of a specific technique. This case report demonstrates the application of successful regional anesthetic management (thoracic epidural anesthesia) in a patient who had been diagnosed with severe idiopathic dilated cardiomyopathy.

Anaesthetic management of a patient with dilated cardiomyopathy for fracture femur surgery-a case report

Dilated cardiomyopathy (DCM) is defined as impairment of the ventricular function of the myocardium. The management of a patient with dilated cardiomyopathy, who undergoes a non-cardiac surgery, is always a challenge for an anaesthesiologist, as this situation is associated with a high mortality rate. We are reporting the successful anaesthetic management of a patient with severe dilated cardiomyopathy for fractured femur surgical repair under graded epidural anaesthesia.

Effects of stem cell therapy on dilated cardiomyopathy

OBJECTIVES

To perform a meta-analysis of clinical trials and investigate the effect of stem cell therapy on dilated cardiomyopathy.

METHODS

A systematic literature search was carried out between May 2012 and July 2013 in PubMed, Medline, Cochrane Library, and Excerpta Medica Database (EMBASE). The study took place in the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China. The weighted mean difference (WMD) was calculated for left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), mortality and heart transplantation, and the 6-minute walk test (6-MWT) distance using the RevMan 5.0 software.

RESULTS

Seven trials with 599 participants evaluated the association between the stem cell therapy and control groups. Compared with the control group, stem cell therapy group improved the LVEF (WMD: 3.98%, 95% confidence interval [CI]: 0.55 - 7.41%, p=0.02) and the 6-MWT distance (WMD: 132.12 m, 95% CI: 88.15-176.09 m, p<0.00001), and reduced mortality and heart transplantation (odds ratio [OR]: 0.48, 95% CI: 0.29-0.80, p=0.005). However, the LVEDD showed no significant difference between the 2 groups (WMD: -1.53 mm, 95% CI: -1.15-0.10 mm, p=0.10).

CONCLUSION

This meta-analysis demonstrated that stem cell therapy improves cardiac function and reduces mortality in dilated cardiomyopathy patients, which suggested that stem cell therapy may represent a new therapy option for dilated cardiomyopathy.