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Titolo:
Cardiomyoplasty: Long-term results in ischemic cardiomyopathy
Autore:
Driever, R; Bugenhagen, R; Fuchs, S; Minale, C; Vetter, HO;
Indirizzi:
Univ Witten Herdecke, Dept Cardiothorac Surg, Ctr Heart, D-42217 Wuppertal, Germany Univ Witten Herdecke Wuppertal Germany D-42217 -42217 Wuppertal, Germany
Titolo Testata:
INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS
fascicolo: 3, volume: 24, anno: 2001,
pagine: 152 - 156
SICI:
0391-3988(200103)24:3<152:CLRIIC>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
CLINICAL FOLLOW-UP; DYNAMIC CARDIOMYOPLASTY; HEART-FAILURE; ASSIST;
Keywords:
cardiomyoplasty; heart failure; treatment outcome; follow-up studies;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Vetter, HO Univ Witten Herdecke, Dept Cardiothorac Surg, Ctr Heart, Arrenberger Str 20, D-42217 Wuppertal, Germany Univ Witten Herdecke Arrenberger Str 20 Wuppertal Germany D-42217
Citazione:
R. Driever et al., "Cardiomyoplasty: Long-term results in ischemic cardiomyopathy", INT J ARTIF, 24(3), 2001, pp. 152-156

Abstract

Introduction: Cardiomyoplasty was introduced into clinical practice in 1985 by Alain Carpentier. Since then, the procedure has been performed on morethan 400 patients worldwide. The latissimus dorsi muscle is prepared maintaining the vascular supply, then the muscle flap is wrapped around the heart and connected to a cardiomyostimulator. The muscle is later stimulated synchronously with ventricular systole to augment the cardiac contractility. Methods: To evaluate the long-term outcome of cardiomyoplasty, we investigated 3 patients electively undergoing this procedure in our hospital. All of these patients (2 male, 1 female) had severe chronic heart failure which did not respond to optimal medical treatment. The mean follow-up time was 42 months (range 24 - 60). All patients showed symptoms corresponding to NYHA class III, and one patient intermittently showed class IV despite conventional medical therapy. Patients were evaluated at 6-month intervals for 2 years with right heart catheterization, radionuclide scans, echocardiography, as well as questionnaires for assessing quality of life. Results: There was no operative mortality One patient experienced sudden death 2 years after operation. There were no significant changes in hemodynamic variables at 6, 12 or 24 months after surgery, respectively. Left ventricular ejection fraction increased from 20.0 (9.2 to 40.0 +/- 7.1 % (p = 0.05) 1 year after operation. Considerable improvement of symptoms was seen in all, and 1 patient returned to work. NYHA-class decreased from 3.1 to 2.0(p = 0.02). Conclusions: Following cardiomyoplasty, patients may exhibit impressive clinical improvement with less striking changes of objective hemodynamic parameters. Thus, in our patients, dynamic cardiomyoplasty improves quality of life. We do not consider this treatment to be an alternative to heart transplantation. It does, however, provide a therapeutic option for patients forwhom transplantation is contraindicated.

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Documento generato il 06/04/20 alle ore 05:34:52