BIOLOGIC CLUE INCREASES CAPILLARY INGROWTH AFTER CARDIOMYOPLASTY IN AN ISCHEMIC CARDIOMYOPATHY MODEL

The authors investigated the multi-step mechanism of healing after car diomyoplasty, focusing on the process of angiogenesis. The authors con tend that enhancement of angiogenesis and prevention of ischemia-reper fusion injuries immediately after muscle mobilization will be effectiv e in improving cardiomyoplasty results. After cardiomyoplasty, autolog ous biologic glue (ABC) was administered between the latissimus dorsi muscle (LDM) and myocardium. By 2 months, a new pseudo interlayer was present that bridged the gap between the LDM and myocardium. Neovascul arization was visible in the form of numerous small capillaries. Marke d degeneration of the LDM was noted, possibly caused by muscle ischemi a-reperfusion damage after mobilization. Pockets were created of ische mic and nonischemic LDM to test for angiogenesis. One was left free of ABG (control); one received ABC only; one received ABG with aprotinin ; and one received ABC with pyrrolostatin. The greatest angiogenesis w as seen with ABC and pyrrolostatin. Some of the capillaries were large and had erythrocytes inside. Biopsy samples showed 9.4 +/- 1.9% of th e sample was occupied by blood vessels (compared with 3.6 +/- 0.7% in control muscle). These preliminary studies prove the feasibility of th e authors' concept and provide evidence that angiogenesis can accelera te the healing process and provide an organic bridge between the LDM a nd myocardium after cardiomyoplasty.