Background. Dynamic cardiomyoplasty has been proposed in the treatment
of severe cardiomyopathies. However, few reports to date have shown s
ignificant numbers of patients collected on a multicenter basis. Metho
ds. From July 1987 to Tune 1994, dynamic cardiomyoplasty was performed
in 112 patients in South America. The indications were dilated cardio
myopathy in 96 patients, Chagas' disease cardiomyopathy in 13, and isc
hemic cardiomyopathy in 3. Left latissimus dorsi muscle was used in al
l patients. Results. The thirty-day mortality rate was 8.1%, and patie
nts were followed up for 22.1 +/- 18.6 months. Data of surviving patie
nts show that 47.3% were in New York Heart Association functional clas
s I, 45.6% in class II, and 7% in class III or IV 1 year after the ope
ration. The 1-year survival was 78.4%; 2-year, 59.7%; and 5-year, 41.7
%. The survival at 1 year was 86.1% for patients with dilated cardiomy
opathy and 40% for those with Chagas' disease. At 5 years, these value
s were 49.8% and 9.5%, respectively. Long-term survival was also signi
ficantly affected by preoperative functional class and pulmonary vascu
lar resistance. However, patients operated on in class III or intermit
tent class IV and without elevated pulmonary vascular resistance had s
urvival rates of 91.5% at 1 year and 76.7% at 5 years of follow-up. Co
nclusions. Cardiomyoplasty improves the functional status of patients
with severe cardiomyopathies. Otherwise, long-term survival after this
procedure is limited in patients with Chagas' disease and by patients
' condition before the operation.