Dilated cardiomyopathy (DCM) in the pediatric population is a rare myocardial disorder that commonly results in congestive heart failure. The majority of patients are idiopathic. Freedom from death or transplantation is disastrous for all categories, particularly those with idiopathic DCMJ Heart transplantation is required for these cases of DCM when medical treatment, such as angiotensin-converting enzyme inhibitors or /?-blockade, or mechanical ventilation and circulatory support do not sufficiently improve the left ventricular (LV) dysfunction. When heart transplantation is performed, it provides superior survival rates: 83% and 63% for 1 year and 10 years, respectively, compared with non-transplant therapy? Unfortunately, however, in Japan small children are not legally provided with any chance for heart transplantation. In addition, the handful of opportunities for transplant tourism to foreign countries will soon be prohibited according to the agreement created in Istanbul in 2008? For the moment, especially in Japan, surgical alternatives for dilated heart failure have gained particular importance in the management of end-stage DCM.
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