Increased coronary artery blood flow with aortomyoplasty in chronic heart failure.
BACKGROUND
We hypothesized that diastolic counter-pulsation using aortomyoplasty will increase coronary blood flow.


METHODS
In dogs (n = 6, 20 to 25 kg), the left latissimus dorsi muscle was isolated, wrapped around the descending thoracic aorta, and conditioned by chronic electrical stimulation. Heart failure was induced by rapid ventricular pacing. In a terminal study, left ventricular and aortic pressures, and blood flow in the left anterior descending coronary artery and descending aorta were measured. The endocardial-viability ratio was calculated.


RESULTS
Aortomyoplasty increased mean diastolic aortic pressure (70 +/- 5 to 75 +/- 5 mm Hg, p < 0.05) and reduced peak left ventricular pressure (86 +/- 4 to 84 +/- 4 mm Hg, p < 0.05), leading to a 16% increase in endocardial-viability ratio (1.29 +/- 0.05 to 1.49 +/- 0.05, p < 0.05). Coronary blood flow was increased by 15% (8.2 +/- 1.5 to 9.4 +/- 1.6 mL/min, p < 0.05). During muscle contraction, 2.7 +/- 0.5 mL was ejected from the wrapped aortic segment.


CONCLUSIONS
These data demonstrate that aortomyoplasty provides successful diastolic counterpulsation after muscle conditioning and heart failure.
Cmolik
B L
BL
Division of Cardiothoracic Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106-5011, USA. blc3@po.cwru.edu
Thompson
D R
DR
Sherwood
J T
JT
Geha
A S
AS
George
D T
DT
D000818:Animals; D018421:Cardiomyoplasty; D015908:Counterpulsation / Q000379:methods*; D004285:Dogs; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D016277:Ventricular Function, Left; D017725:Ventricular Pressure