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Variable effects of cardiomyoplasty on left ventricular function

B B Chiang1, A T Ali, J Storey

  • 1Department of Surgery, University of Louisville School of Medicine, Kentucky, USA.

Artificial Organs
|January 10, 1998
PubMed
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Cardiomyoplasty (CMP) shows inconsistent improvements in heart function shortly after surgery. Active latissimus dorsi muscle assist improved left ventricular systolic function in only 7 of 11 dogs, highlighting variability in early outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Surgical Innovation
  • Heart Failure Treatment

Background:

  • Cardiomyoplasty (CMP) is a surgical option for heart failure.
  • While symptomatic improvement is common, objective measures of cardiac function post-CMP vary significantly.
  • Early post-operative variability in cardiac function following CMP requires investigation.

Purpose of the Study:

  • To assess the variability in left ventricular function shortly after cardiomyoplasty surgery.
  • To determine if active latissimus dorsi muscle (LDM) stimulation impacts cardiac function in the early post-operative period.
  • To identify potential factors contributing to functional variability after CMP.

Main Methods:

  • Cardiomyoplasty was performed on 11 mongrel dogs.

Related Experiment Videos

  • Left ventricular (LV) function was evaluated 9-12 days post-surgery using conductance and Millar catheters.
  • The latissimus dorsi muscle (LDM) was stimulated synchronously with ventricular systole (1:4 to 1:7 ratio) to assess its impact on LV pressure and volume.

    • Main Results:

    • Active LDM stimulation improved left ventricular systolic function in 7 out of 11 dogs.
    • Responders showed statistically significant increases in peak systolic ventricular pressure (PVSP) and stroke work.
    • Four dogs did not respond, indicating inconsistent functional improvement.
    • Variations in PVSP, stroke work, and dP/dt were significant in responders but not in non-responders.

    Conclusions:

    • Active latissimus dorsi muscle assist can improve left ventricular systolic function early after cardiomyoplasty.
    • The functional improvement is inconsistent and varies significantly among individuals.
    • Factors such as LDM integrity, wrapping technique, and adhesions may contribute to early post-operative variability.