Biomechanical characteristics of unconditioned and conditioned latissimus dorsi muscles used for cardiocirculatory assistance.

An understanding of the biomechanical characteristics of striated skeletal muscles involved in cardiocirculatory assistance is a prerequisite to assess their efficacy and to evaluate their haemodynamic benefits. Six goats had their latissimus dorsi muscles evaluated by isometric strain gauge testing. Total tension, and both active and passive force development at different preloads were measured.

Surgical technique for reinforcement cardiomyoplasty.

The current technique for reinforcement cardiomyoplasty in man is detailed. The authors emphasize the critical points that determine the perfect execution of this operation. This innovative surgical approach to heart failure is continuously evolving and, therefore, may be subject to improvement.

Rhythmic and electrophysiological study after dynamic cardiomyoplasty.

To question the possible proarrhythmic effects of cardiomyoplasty (CMP), six adult goats were submitted to rhythmic and electrophysiological (EP) study 15 days before and 8 months after a posteroanterior clockwise CMP procedure using Medtronic Cardiomyostimulator (CMS) (SP1005) and electrodes (SP5528) and completion of a progressive stimulation protocol. Pre and postoperative screening included a surface ECG, 24-hour Holter monitoring, high amplitude and filtered QRS averaging, and invasive EP study performed in the postoperative period with the CMS "ON" and "OFF." One-hour Holter recording with desynchronization of the CMS was obtained.

Pacemaker implantation for early sinus node dysfunction after orthotopic heart transplantation.

Among 60 patients who received OHT at our institution between November 1986 and January 1990, 4 actually needed implantation of a permanent pacemaker. Three patients with symptomatic early sinus node dysfunction were identified and were satisfactorily paced on the VVIR mode. All three showed sinus recovery within three months following implantation and had their pacemaker switched from the VVIR mode to a simple ventricular demand pacing.

Technique for ventricular wrapping in experimental dynamic cardiomyoplasty.

Cardiomyoplasty is a wrapping of an electrostimulated latissimus dorsi muscle flap around the heart for substitution and/or reinforcement. The surgical technique for reproducible cardiomyoplasties in the goat model is presented. The methods combine the direction of wrapping (clockwise, counter-clockwise) and the orientation of muscle fibers.