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Ann Thorac Surg 2001;71:284-289
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Increased coronary artery blood flow with aortomyoplasty in chronic heart failure

Brian L. Cmolik, MDa, Dirk R. Thompson, MSa, J. Timothy Sherwood, MDa, Alexander S. Geha, MDa, David T. George, PhDa

a Division of Cardiothoracic Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

Accepted for publication June 3, 2000.

Address reprint requests to Dr Cmolik, Division of Cardiothoracic Surgery, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106-5011
e-mail: blc3{at}po.cwru.edu

Background. We hypothesized that diastolic counterpulsation using aortomyoplasty will increase coronary blood flow.

Methods. In dogs (n = 6, 20 to 25 kg), the left latissimus dorsi muscle was isolated, wrapped around the descending thoracic aorta, and conditioned by chronic electrical stimulation. Heart failure was induced by rapid ventricular pacing. In a terminal study, left ventricular and aortic pressures, and blood flow in the left anterior descending coronary artery and descending aorta were measured. The endocardial-viability ratio was calculated.

Results. Aortomyoplasty increased mean diastolic aortic pressure (70 ± 5 to 75 ± 5 mm Hg, p < 0.05) and reduced peak left ventricular pressure (86 ± 4 to 84 ± 4 mm Hg, p < 0.05), leading to a 16% increase in endocardial-viability ratio (1.29 ± 0.05 to 1.49 ± 0.05, p < 0.05). Coronary blood flow was increased by 15% (8.2 ± 1.5 to 9.4 ± 1.6 mL/min, p < 0.05). During muscle contraction, 2.7 ± 0.5 mL was ejected from the wrapped aortic segment.

Conclusions. These data demonstrate that aortomyoplasty provides successful diastolic counterpulsation after muscle conditioning and heart failure.




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 J. Thorac. Cardiovasc. Surg.Home page
N. Hedayati, J. T. Sherwood, S. J. Schomisch, J. L. Carino, and B. L. Cmolik
Circulatory benefits of diastolic counterpulsation in an ischemic heart failure model after aortomyoplasty
J. Thorac. Cardiovasc. Surg., June 1, 2002; 123(6): 1067 - 1073.
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