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Cardiomyoplasty: long-term results in ischemic cardiomyopathy
R Driever1, R Bugenhagen, S Fuchs
1Department of Cardiothoracic Surgery, Heart Center, University of Witten/Herdecke, Wuppertal - Germany.
The International Journal of Artificial Organs
|April 21, 2001
Summary
Dynamic cardiomyoplasty improved quality of life in patients with severe heart failure. This surgical procedure augmented cardiac contractility, leading to better clinical outcomes and symptom reduction.
Area of Science:
- Cardiovascular Surgery
- Cardiac Assist Devices
- Regenerative Medicine
Background:
- Cardiomyoplasty, introduced in 1985, involves wrapping a vascularized latissimus dorsi muscle flap around the heart.
- The muscle is stimulated to augment cardiac contractility in patients with severe heart failure.
- Over 400 patients worldwide have undergone this procedure.
Purpose of the Study:
- To evaluate the long-term outcomes of dynamic cardiomyoplasty.
- To assess the impact of the procedure on patients with severe, refractory chronic heart failure.
Main Methods:
- Investigated 3 patients (2 male, 1 female) with NYHA class III-IV heart failure.
- Mean follow-up of 42 months (24-60 months).
- Evaluated using right heart catheterization, radionuclide scans, echocardiography, and quality of life questionnaires at 6-month intervals for 2 years.
Main Results:
- No operative mortality; one late sudden death at 2 years.
- Left ventricular ejection fraction improved significantly from 20% to 40% at 1 year (p=0.05).
- NYHA class improved from 3.1 to 2.0 (p=0.02), with considerable symptom improvement and one patient returning to work.
Conclusions:
- Dynamic cardiomyoplasty demonstrated impressive clinical improvement and enhanced quality of life.
- Objective hemodynamic changes were less striking than clinical improvements.
- Considered a therapeutic option for heart failure patients contraindicated for transplantation.