Electrostimulated cardiomyoplasty: from experimental to clinical studies
| Autor: | Jolanta Vaskelyte, Jolanta Marcinkeviciene, Laima Raliene, Saulius Giedraitis, Arimantas Dumčius, Edmundas Širvinskas, Jonas Skučas, Kęstutis Šalčius |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Sternum medicine.medical_treatment Cardiomyopathy Dogs Postoperative Complications Internal medicine Medicine Animals Humans Cardiomyoplasty Ejection fraction business.industry Latissimus dorsi muscle Hemodynamics Skeletal muscle Dilated cardiomyopathy Stroke Volume General Medicine Stroke volume medicine.disease Electric Stimulation medicine.anatomical_structure Thoracotomy Median sternotomy Echocardiography Cardiology Cardiology and Cardiovascular Medicine business Cardiomyopathies |
| Zdroj: | Pacing and clinical electrophysiology : PACE. 19(8) |
| ISSN: | 0147-8389 |
| Popis: | Cardiomyoplasty is a method for managing patients with dilated cardiomyopathy. We evaluated the means of carbon fiber electrode stimulation of the nerve to the latissimus dorsi muscle (LDM) in dogs to increase skeletal muscle contractility. Histochemical examination of biopsies of muscle electrically conditioned by a single pulse stimulator via the thoracodorsal nerve demonstrated transformation of muscle into fatigue resistant slow fibers without damage to muscle or nerve tissue. Canine experiments confirmed that carbon fibers are one of the best electrodes for chronic LDM stimulation. Between 1988 and 1992, we operated on ten patients, New York Heart Association (NYHA) Class III (4 patients) and Class IV (6 patients), with a mean left ventricular ejection fraction (LVEF) of 23%. The indications for cardiomyoplasty were idiopathic (7 patients) and ischemic (3 patients) cardiomyopathy refractory to maximum medical therapy. The operative procedure was performed via median sternotomy (5 patients) and left thoracotomy (5 patients). There was one operative mortality and two additional deaths during the late follow-up period. The mean postoperative LVEF increased to 27%. Functional class, quality-of-life, and ventricular performance were improved after cardiomyoplasty. Two of the surviving patients are in NYHA Class I, four in Class II, and one in Class III. |
| Databáze: | OpenAIRE |
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