Neovascularization by cardiomyoplasty.
Nowadays cardiomyoplasty is used in cases of cardiac insufficiency as an alternative to cardiac transplant for patients with very developed ischemic cardiopathy, refractory to pharmacological treatment and without possibility of revascularization by using conventional techniques.


OBJECTIVE
Our Cardiovascular Research Group has proposed as an objective, the detection of any possible myocardial neovascularization through the muscle used for cardiomyoplasty. In the case that there are new blood vessels to the diseased myocardium through the latissimus dorsi muscle flap in which it is wrapped and which aids it mechanically, it would be possible to confirm the working hypothesis that cardiomyoplasty not only improves the cardiocirculatory function mechanically but also facilitates a better blood flow to the ischemic myocardium.


METHODS
The cardiomyoplasty technique is described using an experimental model of myocardial ischemia. The vascular cast is achieved by injecting methacrylate simultaneously into both the coronary tree and the wide dorsal muscle. In 15 experiments the connections between the coronary vascular system and the vascular structure of the latissimus dorsil muscle flap are demonstrated by several methods.


CONCLUSIONS
We have demonstrated that cardiomyoplasty, as well as improving ventricular function, favours the revascularization of the myocardium. Cardiomyoplasty could be indicated for cases of ischemic cardiopathy in patients in whom it is not possible to perform direct revacularization using conventional methods.
Borrego
J M
JM
Division of Cardiovascular Surgery and Center for Cardiovascular Research, Hospital Universitario "Virgen del Rocio," Seville, Spain.
Ordonez
A
A
Hernandez
A
A
Perez-Bernal
J
J
Gutierrez
E
E
Garcia-Tejero
P
P
Prieto
M
M
D000818:Animals; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D018421:Cardiomyoplasty; D017023:Coronary Angiography; D003326:Coronary Circulation; D004195:Disease Models, Animal; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D009204:Myocardial Revascularization / Q000379:methods*; D018919:Neovascularization, Physiologic; D013552:Swine