New method for monitoring the functional state of a dynamic cardiomyoplasty.
OBJECTIVE
To assess the impact of a dynamic cardiomyoplasty on failing hearts, it is essential to estimate the contraction force of the skeletal muscle and how its contraction is synchronized with the heart cycle.


METHODS
In a 6-month study a small fluid-filled, balloon-mounted catheter was placed between the myocardium and the muscular wrap in five adult female Boor goats and two female domestic pigs. The catheter was connected to a subcutaneous measuring chamber whereby pressure monitoring could be accomplished. Distinct pressure signals as a result of function of the dynamic cardiomyoplasty and the heart were detected initially in all animals.


RESULTS
Maximal relative pressure from the dynamic cardiomyoplasty was calculated as 336.2% +/- 69.4% on day 24 +/- 6.1 (n = 7) and end-stage pressure as 59.8% +/- 9.7% on day 174.6 +/- 13.1 (n = 4). A functional loss of pressure signals from the dynamic cardiomyoplasty was correlated to severe histologic muscle damage (n = 3). Pressure signals transferred from the contracting myocardium to the catheter showed defined segments of contraction, ejection, and filling periods, allowing a mechanical synchronization of the dynamic cardiomyoplasty to the heart cycle.


CONCLUSIONS
This monitoring catheter enabled the assessment of the functional state of the dynamic cardiomyoplasty and allowed a synchronization to the heart cycle. It will promote understanding and might help to avoid muscle damage in dynamic cardiomyoplasty for an improved outcome of the surgical treatment of end-stage heart failure.
Guldner
N W
NW
Clinic of Cardiac Surgery, Medical University of Lübeck, Germany.
Klapproth
P
P
Hasenkam
J M
JM
Fischer
T
T
Keller
R
R
Noel
R
R
Keding
B
B
Joubert-Hübner
E
E
Kuppe
H
H
Sievers
H H
HH
D000818:Animals; D006328:Cardiac Catheterization / Q000379:methods*; D018421:Cardiomyoplasty; D002404:Catheterization / Q000379:methods*; D005260:Female; D006041:Goats; D008991:Monitoring, Physiologic / Q000379:methods; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000473:pathology / Q000502:physiology; D009200:Myocardial Contraction / Q000502:physiology; D011312:Pressure; D013552:Swine; D013997:Time Factors