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 dilated cardiomyopathy who underwent dynamic cardiomyoplasty and were followed-up for up to 110 months.


RESULTS
Dilated cardiomyopathy was due to undetermined cause in 42 patients (80.8%), Chagas disease in 8 (15.4%), viral infection in 1 (1.9%), and peripartum 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 and 110 months of follow-up. In the chagasic patients the survival rates were 37.5% +/- 17.1%, 12.5% +/- 11.7%, 12.5% +/- 11.7% and 0%, respectively, at 12, 24, 48, and 60 months of follow-up, making chagasic cardiomyopathy a possible contraindication for dynamic cardiomyoplasty.


CONCLUSIONS
There was no correlation between the clinical improvement and hemodynamic data. Ventricular fibrillation was a frequent cause of immediate and late death, suggesting the need for prophylactic use of antiarrhythmic drugs or implantable cardioverter/ defibrillators.
Braile
D M
DM
Faculdade de Medicina de São José do Rio Preto-Medical School FAMERP, and Hospital Beneficência Portuguesa de São José do Rio Preto, São Paulo, Brazil. domingo@braile.com.br
Godoy
M F
MF
Thèvenard
G H
GH
Thèvenard
R S
RS
Braile
M C
MC
Leal
J C
JC
Schaldach
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D018421:Cardiomyoplasty / Q000379:methods*; D002598:Chagas Cardiomyopathy / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015996:Survival Rate; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology