PMID: 9423128Dec 1, 1994Paper

Dynamic cardiomyoplasty: current status and future perspective

Rinshō Kyōbu Geka = Japanese Annals of Thoracic Surgery
R C ChiuK Fuse

Abstract

Dynamic Cardiomyoplasty is a new approach to manage patients with heart failure. The phase I study shows that the muscle stimulator and electrodes function as designed and that the operation is done without any impairment of the patient's motor function. The results of the phase II study has been made public. The hemodynamic effects on patients with dilated cardiomyoplasty have been reported to be excellent. The assisting mechanism of dynamic cardiomyoplasty is based on the conformational change of the wrapped muscle with the ability to restore its optimal length and tension. In the chronic postoperative stage, the muscle seems to form a layer outside the epicardium. This change is important for the myocardinal sparing and girdling effects which are related to the wall stress of the heart. The hypothesis that the wrapped muscle becomes another layer of the heart can explain these effects. Increasing the wall thickness of the left ventricle reduces the wall stress (myocardinal sparing effect) according to Laplace's law. Even if the wrapped muscle is not transformed or stimulated (adynamic cardiomyoplasty), the wall stress is reduced after conformation, and the dilatation of the heart may be protected (girdling effect). The systo...Continue Reading

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