Vascular delay and intermittent stimulation: keys to successful latissimus dorsi muscle stimulation

Kashem, Abul; Santamore, William P.; Chiang, Benjamin; Unger, Lauren; Ali, Ahsan T.; Slater, A. David

doi:10.1016/s0003-4975(01)02571-1

Cited by 9 publications

(2 citation statements)

References 31 publications

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“…Myocardial biopsy or anticoagulation therapy are no needed. A dedicated cardiomyostimulator, which combines work-rest regimen with night/day activity level, is going to be operative, and the vascular delay approach together with the demand stimulation may be the keys of successful LD stimulation [44].…”

Section: Resultsmentioning

confidence: 99%

Dynamic Cardiomyoplasty: Dead or Alive?

Rigatelli¹,

Rigatell²

2011

Int J Angiol

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The dynamic cardiomyoplasty provide an active girdle effect by the wrap of the electrostimulated left latissimus dorsi muscle around the heart. The technique has been almost abandoned in the last five years because the chronic continuous electrical stimulation degenerates the muscle, lowering the long-term results of the intervention. An activity-rest stimulation protocol, which avoid full transformation of the skeletal muscle, maintaining muscular properties overtime, has been proposed showing in humans good results in term of NYHA class, EF and survival improvement. The debate about the capability of this unique kind of cardiocirculatory bio-assist is virtually open: the economic and cost-saving demand dynamic cardiomyoplasty avoiding immunosuppression therapy, extracorporeal circulation equipment and expensive follow-up, probably will be still alive.

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Section: Resultsmentioning

confidence: 99%

Dynamic Cardiomyoplasty: Dead or Alive?

Rigatelli¹,

Rigatell²

2011

Int J Angiol

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“…There have been no large series or even comparative studies, however, which determine the real influence of defibrillators in relation to sudden death or its real impact on the long-term survival of these patients [27]. Technological advances in the development of new cardiomyostimulators [28], new stimulation modes and skeletal muscle graft preservation techniques [29][30][31] represent new perspectives in the establishment of dynamic cardiomyoplasty as a surgical treatment in patients with dilated cardiomyoplasty.…”

Section: Commentsmentioning

confidence: 99%

Risk factors of mortality in nine years of follow-up after dynamic cardiomyoplasty

Benício

Moreira

Bacal

et al. 2003

Rev Bras Cir Cardiovasc

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Purpose: To retrospectively evaluate the survival rate of patients that underwent dynamic cardiomyoplasty, determining the influence of pre-, intra-and post-operative factors and the evolution of left ventricle ejection fraction according to the stimulation mode.Method: Forty-three patients that underwent dynamic cardiomyoplasty between May 1988 and September 1997 were analyzed. Functional class III was predominant (81.4%). The mean left ventricle ejection fraction was 19.37 ± 3.48%. Hospital death was 2.2% and 39 patients who completed the conditioning period had a mean follow up of 46 ± 26 months. Twenty-eight patients were predominantly maintained under stimulation mode 1:1 and 11 under 1:2 stimulation mode.Results: Survival rate at nine years of follow up was 9%. The causes of death were progression of the heart failure and sudden cardiac death. Functional class, the pulmonary vascular-resistance index and stimulation mode were identified as risk factors. The maintenance of the increase of the left ventricle ejection fraction when compared to the preoperative values was more consistent during the studied period when the graft was stimulated in the 1:2 mode.Conclusion: Late results of dynamic cardiomyoplasty are limited by the high incidence of deaths by progression of the heart failure and sudden cardiac death. Survival rate is influenced by the preoperative clinical condition and by the stimulation mode. Muscle graft performance is higher at late follow up with the 1:2 stimulation mode. Descriptors

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