Dynamic cardiomyoplasty: Long-term clinical results in patients with dilated cardiomyopathy

Background. Dynamic cardiomyoplasty has been considered to be an effective method of surgical treatment of patients with end-stage heart failure, and is an alternative to heart transplantation. Methods. We critically evaluated the long-term course of 52 patients with d ilated cardiomyopathy who underwent dynamic cardiomyoplasty and were follow ed-up for up to 110 months. Results. Dilated cardiomyopathy was due to undetermined cause in 42 patient s (80.8%), Chagas disease in 8 (15.4%), viral infection in 1 (1.9%), and pe ripartum cardiomyopathy in 1 (1.9%). In the nonchagasic group the survival rates were 79.5% +/- 6.1%, 67.8% +/- 7.1%, 53.7% +/- 8.3%, 49.9% +/- 8.3%, 14.9% +/- 12.2%, and 14.9% +/- 12.2%, respectively, at 12, 24, 48, 60, 80 a nd 110 months of follow-up. In the chagasic patients the survival rates wer e 37.5% +/- 17.1%, 12.5% +/- 11.7%, 12.5% +/- 11.7% and 0%, respectively, a t 12, 24, 48, and 60 months of followup, making chagasic cardiomyopathy a p ossible contraindication for dynamic cardiomyoplasty. Conclusions. There was no correlation between the clinical improvement and hemodynamic data. Ventricular fibrillation was a frequent cause of immediat e and late death, suggesting the need for prophylactic use of antiarrhythmi c drugs or implantable cardioverter/defibrillators. (C) 2000 by The Society of Thoracic Surgeons.