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Descending thoracic aortomyoplasty: a technique for clinical application
D R Flum1, A C Cernaianu, R Meada
1Department of Surgery, University of Medicine and Dentistry of New Jersey, Cooper Hospital/University Medical Center, Camden, USA.
The Annals of Thoracic Surgery
|January 1, 1996
Summary
This study presents a modified aortomyoplasty technique that preserves intercostal arteries, improving cardiac function. This innovation allows for skeletal muscle-powered cardiac assistance, enhancing aortic pressure and blood flow.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Skeletal Muscle Physiology
Background:
- Descending thoracic aortomyoplasty is a cardiac assistance method using skeletal muscle.
- Clinical use is limited by intercostal artery ligation required for aortic wrapping.
Purpose of the Study:
- To assess the feasibility and efficacy of a modified latissimus dorsi aortomyoplasty.
- To enable aortomyoplasty without ligating intercostal arteries.
Main Methods:
- A pericardial patch was used with latissimus dorsi to preserve intercostal arteries in nine goats.
- Animals underwent a 6-week recovery and a 6-week electrical conditioning program.
- Post-procedure assessment included hemodynamic measurements and aortic imaging.
Main Results:
- Aortomyoplasty activation increased mean diastolic aortic pressure by 23%.
- Significant improvements were observed in cardiac index (40%), stroke volume index (37%), and left ventricular stroke work index (49%).
- Aortic cross-sectional area decreased by 51.8% during activation, confirming effective force transfer, and intercostal arteries remained patent.
Conclusions:
- A modified aortomyoplasty using a pericardial patch effectively assists cardiac function by transferring skeletal muscle force.
- This technique preserves all aortic branches, paving the way for exploring its clinical utility.