Dynamic cardiomyoplasty: A seven-year experience

Since January 1985, the date of the first dynamic cardiomyoplasty, until April 1992, 52 patients (pts) (44 males and 8 females), aged 15 to 68 years (mean 50 years) were operated upon in our Institution. The mean preoperative NYHA functional class was 3.3 and the mean ventricular ejection fraction (EF) was 16±3% at rest. Mean cardiothoracic ratio (CTR) was 54±5%. Maximal oxygen consumption was 12.8 ± 3.5 ml/min/kg. Etiology of cardiac failure was ischemic cardiomyopathy (33), dilated cardiomyopathy (15), cardiac tumor (3), congenital post-Fontan (1). Ventricular failure involved the LV (34), the RV (4), or both ventricles (13). In 44 pts, the cardiomyoplasty was the first cardiac operation, while 8 pts had a previous operation. Surgical techniques consisted of ventricular reinforcement (38), ventricular substitution (13) and atrial reinforcement (1). The left latissimus dorsi muscle (LDM) was wrapped around the ventricles in a clockwise fashion in 46 pts, and in a counter-clockwise fashion in 5 pts. Associated procedures in 23 pts comprised LV aneurism resection (10), valve surgery (9), CABG (8), tumor resection (3). Eighteen patients were assisted perioperatively with an IABP and one with VAD.