PMID- 7669304
OWN - NLM
STAT- MEDLINE
DCOM- 19951019
LR  - 20190913
IS  - 0952-8180 (Print)
IS  - 0952-8180 (Linking)
VI  - 7
IP  - 3
DP  - 1995 May
TI  - Management of anesthesia during dynamic cardiomyoplasty.
PG  - 177-81
AB  - STUDY OBJECTIVE: To review experience with anesthetic management in ten patients 
      undergoing dynamic cardiomyoplasty (CMPL), a new surgical technique that serves 
      as an alternative to heart transplantation. DESIGN: Retrospective clinical study. 
      SETTING: Cardiothoracic operating room at a university hospital. PATIENTS: Ten 
      male functional New York Heart Association (NYHA) class III and IV patients, aged 
      39 to 60 years, awaiting heart transplantation, 7 of whom were diagnosed with 
      dilated cardiomyopathy, 3 with postischemic cardiomyopathy. INTERVENTIONS: Under 
      general anesthesia, the latissimus dorsi muscle was harvested and rotated into 
      the chest through a window in the second rib. The muscle was then wrapped around 
      the heart. Starting from the second postoperative week, the latissimus dorsi was 
      stimulated to provide assistance to a failing heart. MEASUREMENTS AND MAIN 
      RESULTS: The mean left ventricular ejection fraction (LVEF) of the 10 patients 
      was 24.89% +/- 9.17% (range 10% to 37%). No intraoperative death occurred. Two 
      patients died of multiple organ failure and an apparent arrhythmia on the 15th 
      and 25th postoperative days, respectively. The rest of the patients regained good 
      working capacity postoperatively, as evidenced by improvement in NYHA grade. 
      Nevertheless, the LVEF improved in only one patient. No significant differences 
      were evident between preoperative and postoperative blood values, hemodynamic 
      data, or spirometry. CONCLUSIONS: Dynamic CMPL is a considerable challenge for 
      the anesthesiologist because these patients have poor cardiac reserve 
      preoperatively and do not benefit from the procedure in the first two 
      postoperative weeks. To date, CMPL seems to be an important alternative to heart 
      transplantation because experience has shown an improvement in the quality of 
      life with low intraoperative and postoperative complications.
FAU - Domenegati, E
AU  - Domenegati E
AD  - Department of Anesthesia and Intensive Care, S. Matteo Hospital, Pavia, Italy.
FAU - Maurelli, M
AU  - Maurelli M
FAU - Chiaudani, M G
AU  - Chiaudani MG
FAU - Pagnin, A
AU  - Pagnin A
FAU - Rinaldi, M
AU  - Rinaldi M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Anesth
JT  - Journal of clinical anesthesia
JID - 8812166
RN  - CYS9AKD70P (Isoflurane)
SB  - IM
MH  - Adult
MH  - Cardiomyopathy, Dilated/*surgery
MH  - *Cardiomyoplasty
MH  - Electric Stimulation Therapy
MH  - Humans
MH  - *Isoflurane
MH  - Male
MH  - Middle Aged
MH  - Muscle Fibers, Slow-Twitch/surgery
MH  - Myocardial Ischemia/*surgery
MH  - Premedication
MH  - Retrospective Studies
EDAT- 1995/05/01 00:00
MHDA- 1995/05/01 00:01
CRDT- 1995/05/01 00:00
PHST- 1995/05/01 00:00 [pubmed]
PHST- 1995/05/01 00:01 [medline]
PHST- 1995/05/01 00:00 [entrez]
AID - 0952818094000397 [pii]
AID - 10.1016/0952-8180(94)00039-7 [doi]
PST - ppublish
SO  - J Clin Anesth. 1995 May;7(3):177-81. doi: 10.1016/0952-8180(94)00039-7.