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Titolo:
LATISSIMUS-DORSI DYNAMIC CARDIOMYOPLASTY - ROLE OF COMBINED ICD IMPLANTATION
Autore:
THAKUR RK; CHOW LH; GUIRAUDON GM; KOSTUK WJ; BROWN JE; PFLUGFELDER PV; GUIRAUDON CM;
Indirizzi:
THORAC & CARDIOVASC INST,ARRHYTHMIA SERV,405 GREENLAWN,SUITE 110 LANSING MI 48910
Titolo Testata:
Journal of cardiac surgery
fascicolo: 4, volume: 10, anno: 1995,
parte:, 1
pagine: 295 - 297
SICI:
0886-0440(1995)10:4<295:LDC-RO>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
R.K. Thakur et al., "LATISSIMUS-DORSI DYNAMIC CARDIOMYOPLASTY - ROLE OF COMBINED ICD IMPLANTATION", Journal of cardiac surgery, 10(4), 1995, pp. 295-297

Abstract

Latissimus dorsi cardiomyoplasty is a promising surgical therapy in some patients with congestive heart failure. Although the mortality in heart failure patients is attributable primarily to heart failure and ventricular arrhythmias, the mechanism of death after cardiomyoplasty is not well characterized. We describe the clinical course of a patient undergoing cardiomyoplasty and discuss the role of combined use withan implantable cardioverter defibrillator. A 39-year-old man with congestive heart failure due to a massive anterior wall myocardial infarction was evaluated for latissimus dorsi cardiomyoplasty. The patient was in NYHA Functional Class III due to heart failure. He did not have any significant exertional or rest angina. During a Naughton stress test, the patient could exercise for 10 minutes, achieving 4 METS. Pulmonary function study showed a peak V O-2 of 22.1 mL/min per kg. Radionuclide angiography demonstrated that the anterior wall was akinetic with a left ventricular ejection fraction of 22%. Cardiac hemodynamic studies suggested moderate pulmonary hypertension, elevated wedge pressure, and suboptimal response to exercise. A Holter recording showed frequent ventricular extrasystoles. Cardiomyoplasty was preferred to hearttransplantation because the patient did not have end-stage heart failure. Postoperatively, the patient required low doses of dopamine. He developed recurrent, sustained, and hemodynamically significant episodes of ventricular tachycardia. He was treated with a combination of amiodarone and procainamide. He died 2 days postoperatively with ventricular fibrillation. Ventricular arrhythmias are a major cause of death in patients with heart failure. Latissimus dorsi cardiomyoplasty appears to be a promising but unproven therapy in such patients. We suggest that concomitant or preoperative implantation of a cardioverter defibrillator should be considered for future patients undergoing this surgical procedure to prevent sudden arrhythmic deaths.

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Documento generato il 03/04/20 alle ore 19:18:38