[Dynamic cardiomyoplasty. A possible surgical treatment of heart failure]

Dynamic m. latissimus dorsi cardiomyoplasty was introduced in 1985 as a new surgical treatment of terminal heart failure. The latissimus dorsi muscle is wrapped around the heart and paced simultaneously with the heart beat in order to contribute to the systolic function of the failing heart. Although more than 200 patients have received this treatment, the results show a persistent high perioperative mortality (16-25%). However, some patients achieve a considerable improvement in both survival and function, despite the fact that only a minimal improvement of cardiac function can be shown. The advantage of dynamic cardiomyoplasty is that the patient can be operated on in a stable phase. Also, as opposed to heart transplantation, there is no need for immunosuppression. Until further experimental and clinical documentation is available, dynamic cardiomyoplasty is not a realistic alternative to the established surgical and medical treatment of heart failure in Denmark.