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Bilateral latissimus dorsi cardiomyoplasty
J A Magovern1, A P Furnary, I Y Christlieb
1Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212.
The Annals of Thoracic Surgery
|December 1, 1991
Summary
Bilateral latissimus dorsi cardiomyoplasty significantly enhances hemodynamic function compared to unilateral procedures. This surgical approach shows greater augmentation, particularly for right ventricular function, offering improved cardiac support.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Cardiac Physiology
Background:
- Latissimus dorsi cardiomyoplasty is a surgical technique to augment cardiac function.
- Previous studies have explored unilateral applications, but comparative data on bilateral versus unilateral approaches are limited.
Purpose of the Study:
- To test the hypothesis that a bilateral latissimus dorsi cardiomyoplasty provides greater hemodynamic augmentation than a unilateral procedure.
- To compare the hemodynamic effects of different bilateral cardiomyoplasty configurations against a unilateral approach.
Main Methods:
- Eight mongrel dogs underwent two types of bilateral and one left posterior latissimus dorsi cardiomyoplasty.
- R-wave synchronous muscle pacing was achieved using a programmable burst stimulator.
- Hemodynamic variables were compared between stimulated and non-stimulated beats using paired t tests.
Main Results:
- Bilateral cardiomyoplasty significantly increased right ventricular pressure, pulmonary artery pressure, left ventricular pressure, aortic pressure, and peak aortic flow compared to baseline.
- While unilateral (left) cardiomyoplasty also improved these variables, the increases were significantly larger with the bilateral procedure, especially for right ventricular parameters.
- The two tested bilateral configurations (double anterior vs. right anterior/left posterior) yielded comparable results.
Conclusions:
- Both bilateral and unilateral latissimus dorsi cardiomyoplasty can augment systolic ventricular function.
- The bilateral procedure demonstrates superior hemodynamic augmentation, particularly impacting right ventricular function, suggesting its potential for greater cardiac support.