[New configuration of right ventricular dynamic cardiomyoplasty by latissimus dorsi for hypoplastic right ventricle].
The purpose of this experimental study is to evaluate the efficacy of linear-type right ventricular (RV) dynamic cardiomyoplasty in a setting of patch enlargement model for hypoplastic RV. In 6 puppies (6-8 kg), under a cardiopulmonary bypass (CPB), RV free wall and septal traveculation were resected and replaced with large pericardial patch, simulating RV patch enlargement of hypoplastic RV. A pedicled left LD, anchored to 3rd rib, wrapped onto the RV patch in parallel to RV long axis, while LD fixed to only RV diaphragma surface without wrapping LV surface. After the termination of CPB, LD flap was synchronously paced at 1:1 ratio with cardiac beat with a trained-pulse stimuli (10-25 Hz). RV performance was tested by RV function curve (RVSWI vs CVP) and RV pressure-volume relationship (ESPVR) assessed by conductance catheter.


RESULTS
LD graft stimuration showed significant augmentation of PAP (145 +/- 21%), PA flow (152 +/- 21%) and AP (128 +/- 23%) at CVP of 10 mmHg. RV function curve and ESPVR confirmed dramatical augmentation of RV performance by graft stimulation, which was identical to preoperative normal RV function even at the low CVP range.


CONCLUSIONS
Linear LD myoplasty after patch enlargement of RV may viable surgical option for hypoplastic RV.
Morita
K
K
Department of Cardiovascular Surgery, Jikei University School of Medicine, Tokyo, Japan.
Kurosawa
H
H
Ishii
S
S
Koyanagi
K
K
Kanazawa
T
T
Yoshitake
M
M
Nagahori
R
R
D000818:Animals; D018421:Cardiomyoplasty / Q000379:methods*; D002315:Cardiopulmonary Bypass; D004195:Disease Models, Animal; D004285:Dogs; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery*; D013524:Surgical Flaps; D016278:Ventricular Function, Right