Dynamic cardiomyoplasty: a new approach to assist chronic myocardial failure.
The concept of 'reconstructive cardiac surgery' using a stimulated autologous skeletal muscle has been investigated in this research. Our approach has been to investigate the substitution or reinforcement of a ventricular wall by a contractile tissue. The experiments have demonstrated the feasibility of this technique and the long-term adaptability and adequate electrophysiological properties of the Latissimus Dorsi flap transferred to a heterotopic position over the heart. Long-term biocompatible fatigue resistant muscle stimulation has become possible in experimental and clinical cases as a result of the development of specially designed electrodes and the use of a progressive sequential stimulation protocol to adapt the skeletal muscle to a cardiac support function. Autologous pericardium treated with glutaraldehyde was found to be a suitable material to close the ventricular cavity. Cardiomyoplasty with autologous skeletal muscle to restore ventricular contractility seems to be a valid alternative in addition to current methods of treatment for irreversible myocardial failure.
Chachques
J C
JC
Department of Cardiovascular Surgery, University of Paris VI, Hôpital Broussais, France.
Grandjean
P A
PA
Tommasi
J J
JJ
Perier
P
P
Chauvaud
S
S
Bourgeois
I
I
Carpentier
A
A
D000818:Animals; D002303:Cardiac Output, Low / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D002908:Chronic Disease; D004558:Electric Stimulation; D006041:Goats; D006801:Humans; D009132:Muscles / Q000637:transplantation*; D009200:Myocardial Contraction; D013524:Surgical Flaps