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The Annals of Thoracic Surgery, Vol 48, 636-638, Copyright © 1989 by The Society of Thoracic Surgeons
P Brady, T Dionisopoulos, C Desrosiers and RC Chiu
Synchronously stimulated latissimus dorsi muscles have been used for
cardiomyoplasty in adult patients with heart failure. This procedure has
the potential of being used in pediatric patients to enlarge a hypoplastic
ventricle or to reinforce the right atrium in the Fontan procedure. The
growth potential of such a myograft was studied. Young piglets weighing 18
to 22 kg underwent right latissimus dorsi cardiomyoplasty while the
latissimus dorsi weight and myoplasty area were measured. In half of the
animals, the myograft was not stimulated and in the others it was
continuously stimulated with an atrioventricular sequential pacemaker to
contract in synchrony with the heart. Two months later, with doubling of
body weight, the hearts were removed for study. In both groups, significant
(p less than 0.05) increase in latissimus dorsi weight (+92% +/- 15%
nonpaced versus +77% +/- 3% paced) and myoplasty area (+107% +/- 13%
nonpaced versus +116% +/- 30% paced) were noted. The results in stimulated
versus nonstimulated animals were not significantly different. Thus, not
only does cardiomyoplasty offer a contractile tissue to repair or enlarge
cardiac chambers, but this tissue can also grow in young patients and avoid
subsequent size mismatch.
ARTICLES
Growth potential of latissimus dorsi muscle flaps used in the cardiomyoplasty procedure
Division of Cardiovascular and Thoracic Surgery, Montreal General Hospital/McGill University, Quebec, Canada.
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