Related Experiment Videos
The value of the echo-Doppler in cardiomyoplasty procedures
H Almada1, L Molteni, R Ferreira
1Department of Cardiovascular Surgery ECAVI, Hospital Frances, Buenos Aires, Argentina.
Insights
This study found that latissimus dorsi muscle graft cardiomyoplasty improves left ventricular systolic function. Optimal hemodynamic performance was achieved with specific ventricle muscle delays during stimulation.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Biomedical Engineering
Background:
- Latissimus dorsi muscle graft cardiomyoplasty (LDMG) is a surgical procedure to support cardiac function.
- Evaluating the hemodynamic impact of LDMG with varying stimulation delays is crucial for optimizing patient outcomes.
Purpose of the Study:
- To assess the effectiveness of LDMG in improving left ventricular systolic function using Echo-Doppler.
- To determine the optimal ventricle muscle (VM) delay for enhanced hemodynamic performance during LDMG.
Main Methods:
- Two-dimensional echocardiogram and pulsed Doppler were used to measure cardiac parameters in four patients.
- Measurements included left ventricular dimensions, mitral valve function, and aortic root flow.
- Echo-Doppler assessments were performed with the stimulator off and at VM delays of 25, 75, and 250 msec.
Main Results:
- No significant Echo differences were found between stimulator off and on states.
- Optimal hemodynamic performance was observed with VM delays between 75 and 250 msec.
- Improvements included increased aortic peak flow, velocity time integral, ejection period, and reduced pulmonary artery pressure and valve regurgitation.
Conclusions:
- Echo-Doppler demonstrated improved left ventricular systolic function with LDMG support.
- The study suggests that LDMG can enhance cardiac performance, particularly with appropriate stimulation timing.
Unlabelled:
Echo-Doppler determinations were performed in patients submitted to cardiomyoplasty procedure using the latissimus dorsi muscle graft (LDMG). In four patients who had 1 year of follow-up or more the left ventricular internal dimension in diastole (LVIDd), left ventricular internal dimension in systole (LVIDs), septal-E point separation (E-septum), distance of the mitral valve (E-E'), maximal aortic cuspid separation (MACS) and left atrium dimension (LA) were determined by two-dimensional echocardiogram. With a pulsed Doppler in the aortic root the following parameters were obtained: aortic peak flow (AoPF), velocity time integral (VTI), and ejection period (EP). With the stimulator on, the determinations were done using a ventricle muscle (VM) delay of 25, 75, and 250 msec.
Results:
No significant differences were observed by Echo determinations between the stimulator off and on. With the supporting contraction of the LDMG the best hemodynamic performance was obtained when the VM delay ranged between 75 and 250 msec. Values with the stimulator off and on were as follows: AoPF: 90.8 +/- 8 cm/sec and 104.5 +/- 9 cm/sec; VTI: 14.8 +/- 2 cm and 19.2 +/- 2 cm; EP: 230 +/- 10 msec and 245 +/- 20 msec. A decrease in the systolic pressure of the pulmonary artery and a decreased functional regurgitation of the mitral and tricuspid valve were observed in the follow-up determinations. All patients showed restricted mitral flows that remained unchanged during the follow-up.
Conclusions:
In this group of patients the echo-Doppler showed an improvement of the systolic function of the left ventricle when it is supported by the LDMG.(ABSTRACT TRUNCATED AT 250 WORDS)