Dynamic cardiomyoplasty: clinical follow-up results

From 1985 to April 1990, 78 clinical dynamic cardiomyoplasty procedures were performed using the latissimus dorsi muscle stimulated with the Medtronic Cardiomyoplasty System. Indications for surgery were mostly ischemic and idiopathic dilated cardiomyopathies with patients in severe cardiac insufficiency (NYHA Class III and IV). Results of this multicenter study (11 centers) indicate that the dynamic cardiomyoplasty procedure can be transferred and reproduced in many centers with low perioperative mortality and that it improves the functional status of patients who survive the procedure. The survival rate suggests a long-term benefit (average implant time: 11.7 months). Although clinical functional improvement was reported, actual hemodynamic augmentations could not be clearly demonstrated under the protocol. Further studies of functional and hemodynamic parameters are necessary to determine if dynamic cardiomyoplasty is efficacious for a well-defined group of congestive heart failure patients. These points will be addressed in forthcoming studies.