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Ann Thorac Surg 2000;70:1291-1295
© 2000 The Society of Thoracic Surgeons

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Original articles: cardiovascular

Dynamic cardiomyoplasty in a growing organism

^a Department of Cardiac Surgery, Deutsches Herzzentrum Munich, Munich, and Departments of Cardiac Surgery and Pathology, University Hospital Heidelberg, Heidelberg, Germany

Address reprint requests to Dr Voss, Deutsches Herzzentrum Munich, Lazarettstr 36, 80636 Munich, Germany
e-mail: voss{at}dhm.nhn.de

Background. Until now cardiomyoplasty has been a treatment option for adults only. However, there may be a demand for cardiomyoplasty in children. The purpose of this study was to investigate the possibility of applying the method of cardiomyoplasty before growth is completed.

Methods. The latissimus dorsi muscle (LD) was wrapped around the heart of 20 Göttinger Minipigs (9.1 ± 1.2 kg body weight). The LD was fixed to the pericardium in group 1 (n = 11) and to the epimyocardium in group 2 (n = 9) and stimulated with burst impulses. After 5.6 ± 1.8 months hemodynamic and histologic follow-up-examinations were carried out in 13 surviving animals (weight 32.4 ± 5.3 kg).

Results. In group 1 (n = 6) only the left ventricle was covered by the LD. In 4 animals the LD contracted strongly; in 2, the outer border of the muscle was atrophied. In group 2 (n = 7) both ventricles were covered by the LD in all animals and showed strong contractions. In 2 animals the outer border of the muscle was atrophied. In both groups the contracting parts of the LD showed an intact muscle structure, but compared with the contralateral LD, there was a higher percentage of interstitial fat and connective tissue. Hemodynamic measurements and the well-being of the animals suggest that restriction of cardiac chamber diameter did not occur. The electrical stimulation of the LD caused a minimal increase of left ventricular pressure and aortic peak flow in group 2.

Conclusions. Cardiomyoplasty can be applied in a growing organism. There is growth of the LD with the heart. The muscle structure remains intact. To prevent dislocation of the LD, it seems to be important to fix the LD directly onto the epimyocardium.

This article has been cited by other articles:

				B. Voss, F.-U. Sack, W. Saggau, S. Hagl, and R. Lange Atrial cardiomyoplasty in a Fontan circulation Eur. J. Cardiothorac. Surg., May 1, 2002; 21(5): 780 - 786. [Abstract] [Full Text] [PDF]