GROWTH-POTENTIAL AND LEFT-VENTRICULAR DIASTOLIC FUNCTION IN CARDIOMYOPLASTY

Background. Dynamic cardiomyoplasty is an experimental operation for a dvanced heart failure. Current clinical results bring the possibility of its application to children. This study was designed to obtain info rmation about the relationship between cardiomyoplasty and growth of t he heart. Methods. Six beagles, 9 to 10 weeks old, underwent cardiomyo plasty without electric stimulation (cardiomyoplasty group), and anoth er 5 beagles underwent median sternotomy and pericardiotomy (control g roup). Six months later, weights of hearts, wrapped latissimus dorsi m uscles, and unwrapped right latissimus dorsi muscles and pressure-volu me relationships were obtained. Results. Wrapped latissimus dorsi musc les weighed 33 +/- 3 g (mean +/- standard deviation), and unwrapped mu scles weighed 68 +/- 5 g. The heart weight was 82 +/- 3 g in the cardi omyoplasty group and 89 +/- 7 g in the control group. Left ventricular maximum elastance was 3.8 +/- 0.8 mm Hg/mL in the cardiomyoplasty gro up and 3.9 +/- 0.9 mm Hg/mL in the control group. End-diastolic pressu re versus end-diastolic volume ratios were 0.52 +/- 0.03 and 0.54 +/- 0.05, respectively. Pathologic examination showed fat infiltration and muscle fiber atrophy in the cardiomyoplasty group. Conclusions. The w rapped latissimus dorsi muscle flaps were growing and the diastolic fu nction was not impaired. This indicates a potentially safe clinical ap plication of dynamic cardiomyoplasty for children. (C) 1998 by The Soc iety of Thoracic Surgeons.