TECHNICAL NOTES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2002 February;43(1):67-70

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

New hopes for dynamic cardiomyoplasty from use of Doppler flow wire in evaluation of demand stimulation

Rigatelli G. L., Carraro U. *, Barbiero M., Zanchetta M. **, Rigatelli G.

From the Division of Cardiology Interventional Cardiology LAB and Cardiomyoplasty Project Unit Legnago General Hospital, Verona, Italy *Department of Biomedical Sciences University of Padua, Padua, Italy **Division of Cardiology Cittadella General Hospital, Padua, Italy

Background. There ­are no ­data regard­ing ­real car­diac assis­tance in demand dynamic cardiomyoplasty (DDCMP). A ­test of ­the ­use of Doppler ­flow ­wire is pre­sent­ed to dem­on­strate car­diac assis­tance in ­DDCMP.
Methods. Comparative ­study in hos­pi­tal­ized ­care. A periph­er­al FlexTM Doppler ­flow ­wire of 0.018 ­inch ­was ­advanced ­through a 4F intro­duc­er femo­ral arte­ri­al in sev­en ­DDCMP ­patients (­age=57.1±6.2 ­years; ­NYHA= 1.4±0.5). A ­short peri­od of 10 sec­ ­with stim­u­la­tor ­off ­and a fol­low­ing peri­od of 15 sec ­with clin­i­cal stim­u­la­tion ­were record­ed. We meas­ured ­the max­i­mum ­peak aor­tic ­flow veloc­ity (­MPAV) in ­all ­beats. Latissimus dor­si (LD) mech­a­no­gram ­was simul­ta­ne­ous­ly record­ed.
Results. Statistical anal­y­sis ­showed an ­increase ­not ­only in ­MPAV in assist­ed peri­od ver­sus ­rest, ­but ­also in assist­ed ­beats ver­sus unas­sist­ed (8.42±6.98% ­and 7.55±3.07%).
Conclusions. Intravascular Doppler ­proved ­real sys­tol­ic assis­tance in ­DDCMP; in ­DDCMP sys­tol­ic assis­tance is cor­re­lat­ed to ­the LD ­wrap ­speed of con­trac­tion, sug­gest­ing ­that ­demand stim­u­la­tion ­could be ­the ­most effec­tive pro­to­col in dynam­ic car­di­om­yo­plas­ty.