A COMPARISON OF THE EARLY AND MIDTERM RESULTS AFTER DYNAMIC CARDIOMYOPLASTY IN PATIENTS WITH ISCHEMIC OR IDIOPATHIC CARDIOMYOPATHY

Objective: The main goal of this study is to determine the efficiency of the cardiomyoplasty procedure on patients with cardiomyopathy of di fferent origins (ischemic and idiopathic origins), Method: Between Jun e 1993 and August 1995, 24 patients underwent dynamic cardiomyoplasty with the left latissimus dorsi muscle in our institution, Early and mi dterm results, as well as the changes in hemodynamics and functional s tatus during followup, were compared, Results: Early mortality rate wa s 20.8% (five patients), Concomitant coronary revascularization, a pre operative left ventricular ejection fraction below 20%, and a function al capacity of class IV (intermittently) were associated with early mo rtality, The mean follow-up time was 17.3 months, Survival analysis (i ncluding early mortality) extending to the twenty-fourth month reveale d no difference between the ischemic and idiopathic groups (55% vs 85% , respectively, p = 0.09), Functional status improved in the both grou ps, Ejection fractions were improved after cardiomyoplasty in all pati ents, regardless of their cause, Cardiac indices were higher 6 months after the operation, Changes in pulmonary capillary wedge pressure, pe ak pulmonary artery pressure, and left ventricular end-diastolic volum e were not significant, Conclusion: Although cardiomyoplasty improves functional capacity and hemodynamics in patients with both idiopathic and ischemic cardiomyopathy, the idiopathic group is thought to achiev e optimal benefit with regard to lower complication rates and lower ea rly mortality expectancy owing to the absence of concomitant coronary revascularization.