HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Michael A. Acker Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Acker, M. A. Search for Related Content PubMed PubMed Citation Articles by Acker, M. A.

Ann Thorac Surg 1999;68:750-755
© 1999 The Society of Thoracic Surgeons

---

Alternatives To Transplantation

Dynamic cardiomyoplasty: at the crossroads

^a Division of Cardiothoracic Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

Address reprint requests to Dr Acker, Division of Cardiothoracic Surgery, University of Pennsylvania Medical Center, 3400 Spruce St, 4 Silverstein Pavilion, Philadelphia, PA 19104
e-mail: macker{at}mail.med.upenn.edu

Presented at the Fourth International Conference on Circulatory Support Devices for Severe Cardiac Failure, Houston, TX, Oct 3–5, 1997.

Abstract

Background. Dynamic cardiomyoplasty remains a promising, but still unproven surgical treatment for patients with end-stage heart failure. Lack of a clear survival advantage and ongoing misunderstanding of its mechanism of action have hindered its acceptance as a treatment alternative for patients with end-stage heart failure. This review seeks to update current clinical results and practice of dynamic cardiomyoplasty and to present its likely mechanism of action.

Methods. The method involved a literature review.

Results. More than 600 patients have undergone dynamic cardioplasty since 1985. Improvement in average New York Heart Association class was noted in 80% to 85% of hospital survivors. Operative mortality has decreased from 31% in Phase I to less than 3% in the ongoing Phase III trial. Clinical work as well as recent animal work supports the hypothesis that through a combination of long-term elastic constraint and active dynamic assist, dynamic cardiomyoplasty decreases myocardial wall stress associated with the remodeling process of progressive heart failure.

Conclusions. Though dynamic cardiomyoplasty can be shown to limit the remodeling process of heart failure in animal studies and some patients, its ultimate role in the treatment of heart failure will depend on the outcome of randomized, controlled studies.

This article has been cited by other articles:

				G. V. Letsou, J. E. Carter, S. Shenaq, I. D. Gregoric, R. Delgado, and O. H. Frazier Orthotopic cardiac transplantation 30 months after successful dynamic cardiomyoplasty Ann. Thorac. Surg., October 1, 2003; 76(4): 1289 - 1291. [Abstract] [Full Text] [PDF]

				A. Benicio, L. F. P. Moreira, F. Bacal, N. A. G. Stolf, and S. A. Oliveira Reevaluation of long-term outcomes of dynamic cardiomyoplasty Ann. Thorac. Surg., September 1, 2003; 76(3): 821 - 827. [Abstract] [Full Text] [PDF]

				O. Kawaguchi, Y. F. Huang, T. Yuasa, K. Shirota, R. A. J. Carrington, and S. N. Hunyor Cardiomyoplasty reduces myocardial oxygen consumption: implications for direct mechanical compression Ann. Thorac. Surg., October 1, 2002; 74(4): 1092 - 1096. [Abstract] [Full Text] [PDF]

				V. S Chekanov, D. E Sands, C. S Brown, F. Brum, P. Arzuaga, S. Gava, F. P Eugenio, V. Melamed, and H. W Spencer Cardiomyoplasty: First Clinical Case With New Cardiomyostimulator Asian Cardiovasc Thorac Ann, September 1, 2002; 10(3): 264 - 266. [Abstract] [Full Text] [PDF]

				M. Murtra The adventure of cardiac surgery Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 167 - 180. [Full Text] [PDF]

				H. M. Spotnitz Macro design, structure, and mechanics of the left ventricle J. Thorac. Cardiovasc. Surg., May 1, 2000; 119(5): 1053 - 1077. [Full Text] [PDF]