[Cardiomyopexy--current status of an indirect revascularization method]

Area of Science:

• Cardiovascular Surgery
• Regenerative Medicine
• Ischemic Heart Disease

Context:

• Patients with diffuse coronary stenosis unsuitable for traditional bypass surgery often experience severe angina.
• Limited treatment options exist for patients with complex coronary artery disease and heart failure.

Purpose:

• To evaluate the efficacy and safety of indirect myocardial revascularization (myocardioplasty) using free latissimus dorsi muscle flaps.
• To assess the impact of this procedure on angina symptoms and exercise capacity in patients with end-stage coronary artery disease.

Summary:

• Six patients with severe coronary stenosis and angina underwent indirect myocardial revascularization with a free skeletal muscle flap (musculus latissimus dorsi).
• The muscle flap's artery was anastomosed to the aorta, and venous drainage was directed to the right atrium.
• Post-procedure, patients reported significant angina relief within 4 weeks and improved exercise tolerance, with sustained benefits observed in long-term follow-up.

Impact:

• Indirect myocardial revascularization offers a viable alternative for patients with complex coronary artery disease who are not candidates for conventional surgery.
• This technique demonstrates potential for improving myocardial function and quality of life in refractory ischemic heart conditions.