Thoracoscopic Cardiomyoplasty: a Canine Feasibility Study

Background. Thoracoscopy may be effective in reducing the surgical stress of cardiomyoplasty. The feasibility of thoracoscopy in cardiomyoplasty was investigated. Methods. Cardiomyoplasty by thoracoscopy and by the open method through a thoracotomy was performed in dogs. After 8 to 10 weeks of preconditioning, the hemodynamic effect of burst stimulation was measured. Results. Cardiomyoplasty by thoracoscopy took 90 ± 21 minutes (mean ± standard deviation), whereas cardiomyoplasty by the open method took 67 ± 10 minutes (p < 0.05). As a result of burst stimulation, aortic pressure, descending aortic flow, and left atrial pressure increased by 15.1% ± 6.5%, 8.6% ± 6.3%, and 3.8% ± 4.6%, respectively, in the dogs that received the cardiomyoplasty by thoracoscopy, whereas those indices increased by 16.5% ± 6.9%, 9.8% ± 5.9%, and 4.8% ± 4.2%, respectively, in dogs that received cardiomyoplasty by the open method. No significant difference between the two groups was shown in any index. Conclusions. Cardiomyoplasty by thoracoscopy was technically practical, and its hemodynamic effect was similar to that of the open method. The feasibility of cardiomyoplasty by thoracoscopy was thereby suggested. (Ann Thorac Surg 1997;63:477–81)