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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 April;40(2):217-22

CARDIAC PAPERS 

    ORIGINAL ARTICLES

Unpre­con­di­tioned ­free revas­cu­lar­ized dynamic car­di­om­yo­plasty Is it fea­sible?

Chen Y. S., Yu H. Y., Ko W. J., Chu S. H.

From the Depart­ment of Sur­gery National ­Taiwan Uni­ver­sity Hos­pital Taipei, ­Taiwan
* Department of Surgery Chi-Mei Foundation Hospital, Tainan, Taiwan

Back­ground. Car­di­om­yo­plasty is a new ven­tric­ular bio-­assist ­device for myo­car­dial ­failure. But there are ­some lim­i­ta­tions in stan­dard car­di­om­yo­plasty, ­such as the orien­ta­tion of the ­muscle and ­fiber and the effi­ciency of the con­trac­tile seg­ment of the ­flap. ­Free revas­cu­lar­ized lat­is­simus ­dorsi ­flap may be a ­good ­idea for ­solving ­these prob­lems.
­Methods. We ­designed a ­canine ­free lat­is­simus ­dorsi ­flap by revas­cu­lar­izing the ­flap ­with the ­left ­internal tho­racic ves­sels by ­micro-sur­gical tech­nique. ­Group I (n=3) as con­trol was per­formed by stan­dard car­di­om­yo­plasty, and the ­Group II (n=10) was per­formed by the revas­cu­lar­ized ­method. The ­heart was ­then ­wrapped by the revac­ular­ized ­flap. ­Group II was ­divided ­into IIa (n=6, no pre-treat­ment ­before revas­cu­lar­iza­tion) and IIb (n=4, ­normal ­saline pre-treat­ment ­before revas­cu­lar­iza­tion) by the dif­ferent pres­er­va­tion ­methods. Hemo­dy­namic ­data ­were ­recorded.
­Results. ­Group I all sur­vived the 8-­week ­training ­period. But ­Group II, ­Group IIa and IIb, all ­died in 3 ­days, but sur­vived ­more ­than 12 ­hours. The hemo­dy­namic anal­ysis in ­Group I did not ­show any sig­nif­i­cant ­change ­except ­left ven­tric­ular end dia­stolic pres­sure. It ­showed ele­vated ­left ven­tric­ular pres­sure ­when the car­di­os­tim­u­lator was ON.
Con­clu­sions. ­According to the ­result of ­this experi­ment, it ­seemed impos­sible to get a sat­is­fac­tory ­result of ­more ­than 3 ­days for ­free revas­cu­lar­ized car­di­om­yo­plasty at ­present. ­There ­were a lot of prob­lems ­waiting to be ­solved, ­such as pres­er­va­tion ­method ­during ­ischemia, ­bulky ­mass of the ­flap, and the poten­tial ­problem of neu­ro­mus­cular ­atrophy.

language: English


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