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The Annals of Thoracic Surgery, Vol 56, 867-870, Copyright © 1993 by The Society of Thoracic Surgeons
ER Capouya, RS Gerber, DC Drinkwater Jr, JM Pearl, JB Sack, AS Aharon, SW Barthel, EM Kaczer, PA Chang and H Laks
The precise hemodynamic effects of latissimus dorsi cardiomyoplasty have
not been well characterized. We prospectively studied 11 mongrel dogs using
a rapid ventricular pacing model of congestive heart failure. Six dogs
received a nonstimulated left latissimus dorsi cardiomyoplasty wrap, and 5
control dogs were paced only. Two- dimensional transthoracic
echocardiography was performed on all dogs at baseline and then weekly for
4 weeks. Measurements obtained included left ventricular diameters,
lengths, volumes, and ejection fractions. Progressive left ventricular
enlargement, increase in volumes, and worsening ejection fractions
developed in both groups. However, less left ventricular dilatation and
higher ejection fractions were seen in dogs that received a cardiomyoplasty
wrap. A nonstimulated cardiomyoplasty wrap significantly attenuated the
degree of left ventricular enlargement, increase in left ventricular
volumes, and decrease in ejection fraction in a rapid pacing model of
congestive heart failure. Apart from its effect on systolic augmentation
with a stimulated muscle wrap, cardiomyoplasty may have an important
"girdling" effect on the left ventricle that prevents dilatation and
deterioration of left ventricular function.
ARTICLES
Girdling effect of nonstimulated cardiomyoplasty on left ventricular function
Department of Surgery, University of California, Los Angeles, Medical Center 90024-1741.
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