Clinical analysis of diagnose and treatment in heart failure due to pediatric primary cardiomyopathy

Abstract

Objective To observe diagnostic criteria and treatment of heart failure in pediatric primary cardiomyopathy, improve diagnostic standardization and therapeutic efficiency of pediatric heart failure. Analyse the mechanism of LVAD (left ventricular assist device). Methods There were 44 cases of heart failure in DCM and EFE from March 1995 to March 2006, analysed and compared with their clinical signs, CTR, EF and FS. The patients in routine group were treated by routine therapy for heart failure (digitalis, diuretics and vasodilator) and 10 patients were treated byβ-blocker on the basic of routine therapy. The therapeutic effects in the two groups were observed. LVAD (Berlin Heart System)was undertaken to replace the pump function of ventricle in these patients who had been unresponsive to drugs and developed severe heart failure. Results In 25 children in DCM group with heart failure, the average of CTR is (68 ± 5. 9)%, with hepatomegaly 19 cases (19/25),with tachypnea 21 cases(21/25). In19 children in EFE group with heart failure, the average of CTR is 67±6. 02%, with hepatomegaly 9cases(9/19), with tachypnea 16 cases(16/19). The average of EF in DCM group is 39 ± 11. 9%, FS is 16.57 ± 5. 59%. In EFE group, EF is 48 ± 10. 8%, FS is 20 ± 5. 97. After treatment by routine therapy for heart failure, Cardiac function were improved in most of patients, but 2 patients died. 10 patients were treated by routine therapy plus β-blocker, all have improving cardiac function till now. In medical university of Innsburck, LVAD was utilized in a 6 months boy. LVAD first in a 40 months boy, then changed to BIVD for the right heart failure. BIVD in a 13 years girl. Conclusion The important role of EF and FS in children patients with heart failure should be focused on. At the same time, emphasizing on standardization in methods of subjective examination. The therapeutic effect of routine therapy plusp-blocker is much better than that of simple routine therapy. As a new technique in the treatment of children heart failure patients, LVAD has achieved good effects in the therapy of primary pediatric cardiomyopathy cases and is worth further effort in pediatric field. Key words: primary cardiomyopathy; heart failure; LVAD; pediatric