REGIONAL EFFECTS OF AORTOMYOPLASTY IN ACUTE-ISCHEMIA

Background. Aortomyoplasty is a technique for achieving autogenous dia stolic counterpulsation. This experiment was designed to determine if aortomyoplasty using conditioned latissimus dorsi muscle could improve regional myocardial function during coronary ischemia. Methods. Six m ongrel dogs underwent a staged operation in which the left latissimus dorsi was conditioned in situ for 4 weeks, then wrapped around the des cending aorta and stimulated during diastole with each cardiac contrac tion. Regional ischemia was caused by occlusion of the left anterior d escending coronary artery. Regional function was measured with sonomic rometry in the region of ischemia and in a control area. An intraaorti c balloon pump was inserted for comparison with aortomyoplasty perform ance. Results. Coronary artery occlusion caused a significant decrease in the percentage of regional shortening (14.2 +/- 7.9 to -2.2 +/- 4. 0; p = 0.001) and thickening (11.9 +/- 4.6 to -5.8 +/- 3.3; p < 0.001) . Aortomyoplasty improved regional motion in both percentage shortenin g (-2.2 +/- 4.0 to 2.3 +/- 3.7; p = 0.008) and thickening (-5.8 +/- 3. 3 to 2.8 +/- 1.9; p < 0.001). The intraaortic balloon pump also improv ed percentage shortening (-3.7 +/- 2.0 to 0.7 +/- 1.9; p = 0.01) and t hickening (-5.0 +/- 2.8 to 2.4 +/- 3.8; p < 0.001), and was not signif icantly different than aortomyoplasty. Conclusions. These data show th at aortomyoplasty has beneficial effects on ischemic left ventricular contractility, and may therefore be useful for treating inoperable cor onary artery disease.