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Dynamic cardiomyoplasty is a new procedure for patients approaching heart failure. The process involves wrapping the latissimus dorsi muscle around the heart to augment the function of weakened ventricles. However, the survival rates of the procedure remain low. Three out of 10 patients die within one year of the operation and at least one out of 10 die during the operation. Care for a patient undergoing dynamic cardiomyoplasty is described., Cardiomyoplasty, a new and still experimental procedure, offers some patients with heart failure a new lease on life. Despite advances in medical and surgical treatments, 200,000 people die from heart [...]

Twelve men aged 45 to 69 years, NYHA class 3 or 4 with low isotopc ejection fraction (18±7 percent), underwent cardiomyoplasty. Eight required cardiopulmonary bypass to treat an associated cardiac [...]

The use of skeletal muscle to assist the heart was proposed over 30 years ago, but skeletal muscle was unable to adjust to the continuous work required to augment the beating of the heart. New techniques using the latissimus dorsi, one of the two triangular muscles on the back, have had some success. The muscle is brought into the chest, and either wrapped around the heart (cardiomyoplasty) or made to provide counterpulsation of the aorta, the large blood vessel leaving the heart. Programmable pacemakers sense the electrical activity of the heart and stimulate the muscle at appropriate intervals. Over 100 cardiomyoplasties have now been performed, and although many patients report an improvement in symptoms, clinical improvements have been difficult to document. At the same time, animal experiments have provided conflicting results. The improvement in symptoms may simply be a result of a reduction in stress on the heart wall because the amount of dilatation is reduced. A recent Brazilian study reported clinical improvement and longer survival among patients who underwent cardiomyoplasty, but no other study has found increased survival rates. The formation of auxiliary pumping chambers from skeletal muscle pouches or ventricles has been tested in dogs, one of which is still alive after one year. Various counterpulsation techniques, in addition to the use of skeletal muscle, are also being investigated, including the intra-aortic (inside the aorta) balloon pump, already widely used for short-term assistance to the heart. (Consumer Summary produced by Reliance Medical Information, Inc.)

Giving Hearts New Muscle Gets Tentative Support Pittsburgh--Early clinical results involving skeletal-muscle heart supports have left investigators here cautious but encouraged about the technique's potential as an aid for failing […]