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Dynamic cardiomyoplasty in a growing organism
B Voss1, M Thielmann, M El-Mehsen
1Department of Cardiac Surgery, Deutsches Herzzentrum Munich, Germany. voss@dhm.nhn.de
The Annals of Thoracic Surgery
|November 18, 2000
Summary
This study shows cardiomyoplasty is feasible in growing organisms. The latissimus dorsi muscle (LD) grows with the heart, maintaining its structure, and direct epimyocardial fixation is key.
Area of Science:
- Cardiovascular Surgery
- Regenerative Medicine
- Pediatric Cardiology
Background:
- Current cardiomyoplasty is limited to adult patients.
- Potential demand exists for pediatric cardiomyoplasty.
- Investigating pediatric application requires studying growth in vivo.
Purpose of the Study:
- To assess the feasibility of cardiomyoplasty in a growing organism.
- To evaluate the latissimus dorsi muscle's adaptation to cardiac growth.
- To determine optimal fixation methods for pediatric cardiomyoplasty.
Main Methods:
- Latissimus dorsi (LD) muscle wrapping around the heart in 20 Göttinger Minipigs.
- Two fixation groups: pericardium (Group 1) vs. epimyocardium (Group 2).
- Post-operative hemodynamic and histologic assessments after 5.6 months.
Main Results:
- Both ventricles were covered in Group 2, showing strong LD contractions.
- LD muscle structure remained intact, with some interstitial fat/connective tissue increase.
- No cardiac chamber restriction observed; minimal increase in left ventricular pressure and aortic flow in Group 2.
Conclusions:
- Cardiomyoplasty is applicable in growing organisms.
- The latissimus dorsi muscle exhibits growth in synchrony with the heart.
- Direct epimyocardial fixation is crucial to prevent LD dislocation.