THE USE OF LATISSIMUS-DORSI MUSCLE FLAP IN RECONSTRUCTIVE HEART-SURGERY

Dynamic cardiomyoplasty is a technique for ventricular assistance indi cated for the correction of left ventricle aneurysm and for cardiomyop athies in which heart transplantation is contraindicated. In this arti cle, our first four patients to undergo cardiomyoplasty (from February 1991 until April 1992) with a left latissimus dorsi island flap, rota ted into the thorax after a 3-week training period, are reviewed. Ther apeutic indications were cardiomyopathy with contraindication for hear t transplant in patients 1 and 4 and associated to surgery for left ve ntricle aneurysm for patients 2 and 3. Patient 1 died 4 months after s urgery because of a cerebral embolism when he was at functional class II. The other three patients remain at functional class I, carrying ou t normal activities. All the data were evaluated with the paired t tes t. Ejection fraction values (obtained through echocardiography and sci ntigraphy studies) and maximum minute flow rate of blood (measured wit h an echo-Doppler) have increased significantly (p < 0.001, p < 0.05, and p < 0.01, respectively) after heart surgery. Clinical improvement has been found after cardiomyoplasty, which correlates with an increas e in ejection fraction and maximum minute flow rate of blood.