THORACOSCOPIC CARDIOMYOPLASTY - A CANINE FEASIBILITY STUDY

Background. Thoracoscopy may be effective in reducing the surgical str ess of cardiomyoplasty. The feasibility of thoracoscopy in cardiomyopl asty was investigated. Methods. Cardiomyoplasty by thoracoscopy and by the open method through a thoracotomy was performed in dogs. After 8 to 10 weeks of preconditioning, the hemodynamic effect of burst stimul ation was measured. Results. Cardiomyoplasty by thoracoscopy took 90 /- 21 minutes (mean +/- standard deviation), whereas cardiomyoplasty b y the open method took 67 +/- 10 minutes (p < 0.05). As a result of bu rst stimulation, aortic pressure, descending aortic flow, and left atr ial pressure increased by 15.1% +/- 6.5%, 8.6% +/- 6.3%, and 3.8% +/- 4.6%, respectively, in the dogs that received the cardiomyoplasty by t horacoscopy, whereas those indices increased by 16.5% +/- 6.9%, 9.8% /- 5.9%, and 4.8% +/- 4.2%, respectively, in dogs that received cardio myoplasty by the open method. No significant difference between the tw o groups was shown in any index. Conclusions. Cardiomyoplasty by thora coscopy was technically practical, and its hemodynamic effect was simi lar to that of the open method. The feasibility of cardiomyoplasty by thoracoscopy was thereby suggested. (C) 1997 by The Society of Thoraci c Surgeons.