PMID- 9370399
OWN - NLM
STAT- MEDLINE
DCOM- 19971211
LR  - 20190512
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 12
IP  - 4
DP  - 1997 Oct
TI  - Dynamic cardiomyoplasty: clinical follow-up at 12 years.
PG  - 560-7; discussion 567-8
AB  - OBJECTIVE: The purpose of this study is to evaluate the long-term outcome of 
      dynamic cardiomyoplasty. This surgical technique was conceived to assist the 
      failing heart. The many proposed mechanisms of action of cardiomyoplasty are: (1) 
      systolic assist; (2) limitation of ventricular dilation; (3) reduction of 
      ventricular wall stress (sparing effect); (4) ventricular remodeling with an 
      active girdling effect; (5) angiogenesis; and (6) a neurohumoral effect. METHODS: 
      We investigated 95 patients in our hospital undergoing this procedure due to 
      severe chronic heart failure, refractory to optimal medical treatment. Patients 
      had a mean age of 51 +/- 12 years. The etiology of heart failure was ischemic 
      55%, idiopathic 34%, ventricular tumor 6%, and other 5%. The mean follow-up was 
      44 months. RESULTS: The mean New York Heart Association (NYHA) functional class 
      improved postoperatively from 3.2 to 1.8. Average radioisotopic left ventricular 
      (LV) ejection fraction increased from 17 +/- 5 to 27 +/- 4% (P < 0.05). Stroke 
      volume index increased from 32 +/- 7 to 43 +/- 8 ml/beat per m2 (P < 0.05). The 
      heart size remained stable over the long term. Following cardiomyoplasty, the 
      number of hospitalizations due to congestive heart failure was reduced to 0.4 
      hospitalizations/patient per year (preoperative: 2.5, P < 0.05). Computed 
      tomography scans showed at long term a preserved latissimus dorsi muscle 
      structure in 84% of patients. Survival probability at 7 years is 54%. Six 
      patients underwent heart transplant after cardiomyoplasty (mean delay: 25 
      months), due to the natural evolution of their underlying heart disease. There 
      were no specific technical difficulties. CONCLUSIONS: Clinically, this procedure 
      reverses heart failure, improves functional class and ameliorates quality of 
      life. The latissimus dorsi muscle histological structure is maintained at 
      long-term, when postoperative electrostimulation is performed, avoiding excessive 
      stimulation. Cardiomyoplasty may delay or prevent the progression of heart 
      failure and the indication of cardiac transplantation.
FAU - Chachques, J C
AU  - Chachques JC
AD  - Department of Cardiovascular Surgery, Broussais Hospital, Paris, France.
FAU - Marino, J P
AU  - Marino JP
FAU - Lajos, P
AU  - Lajos P
FAU - Zegdi, R
AU  - Zegdi R
FAU - D'Attellis, N
AU  - D'Attellis N
FAU - Fornes, P
AU  - Fornes P
FAU - Fabiani, J N
AU  - Fabiani JN
FAU - Carpentier, A
AU  - Carpentier A
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Actuarial Analysis
MH  - *Cardiomyoplasty/mortality
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/mortality/*surgery
MH  - Heart Transplantation/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 1997/11/25 00:00
MHDA- 1997/11/25 00:01
CRDT- 1997/11/25 00:00
PHST- 1997/11/25 00:00 [pubmed]
PHST- 1997/11/25 00:01 [medline]
PHST- 1997/11/25 00:00 [entrez]
AID - S1010-7940(97)00214-5 [pii]
AID - 10.1016/s1010-7940(97)00214-5 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 1997 Oct;12(4):560-7; discussion 567-8. doi: 
      10.1016/s1010-7940(97)00214-5.