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Present Trends in Clinical Experience with Dynamic Cardiomyoplasty

Moreira, Luiz Felipe P. ; Bocchi, Edimar A. ; Bacal, Fernando ; Stolf, Noedir A. G. ; Bellotti, Giovanni ; Jatene, Adib D.

Artificial organs, 1995-03, Vol.19 (3), p.211-216 [Periódico revisado por pares]

Oxford, UK: Blackwell Publishing Ltd

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  • Título:
    Present Trends in Clinical Experience with Dynamic Cardiomyoplasty
  • Autor: Moreira, Luiz Felipe P. ; Bocchi, Edimar A. ; Bacal, Fernando ; Stolf, Noedir A. G. ; Bellotti, Giovanni ; Jatene, Adib D.
  • Assuntos: Adolescent ; Adult ; Cardiomyopathies - complications ; Cardiomyopathy ; Cardiomyoplasty ; Female ; Heart failure ; Heart Failure - etiology ; Heart Failure - mortality ; Heart Failure - surgery ; Humans ; Male ; Mechanical properties ; Middle Aged ; Quality of Life ; Survival Rate ; Ventricular function ; Ventricular Function, Left
  • É parte de: Artificial organs, 1995-03, Vol.19 (3), p.211-216
  • Notas: ark:/67375/WNG-HN9DNMN1-V
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    content type line 23
  • Descrição: : Dynamic cardiomyoplasty has been performed to reinforce the myocardium in the treatment of patients with severe cardiomyopathies. At the Heart Institute of S˜o Paulo University Medical School, 36 patients were submitted to cardiomyoplasty between May 1988 and December 1993. The indications were idiopathic dilated car‐diomyopathy in 31, ischemic cardiomyopathy in 3, and Chagas' disease cardiomyopathy in 2 patients. Twenty‐eight patients were categorized in New York Heart Association (NYHA) Class III and 8 in Class IV despite the use of maximal medical therapy. There were no hospital deaths, and patients were followed up from 2 to 70 months (mean, 24 months). Besides the improvement of NYHA functional class from 3.2 ± 0.6 to 1.6 ± 0.9 at 6 months of follow‐up, patients also presented significant changes in the left ventricular systolic and diastolic functions. Nevertheless, 16 patients died, and 2 patients were submitted to heart transplantation during late follow‐up. Actuarial survival rates were 82.3% at 1 year, 61.5% at 2 years, and 38.8% at 5 years of follow‐up. Otherwise, the analysis of factors influencing the outcome showed that long‐term survival was significantly affected by preoper‐ative functional class and by pulmonary vascular resistance. The 26 patients operated in NYHA functional Class III and with pulmonary vascular resistance below 4 Wood units presented survival rates of 72.7% at 2 years and of 63% at 5 years of follow‐up. In conclusion dynamic cardiomyoplasty improves functional class and left ventricular function in patients with severe cardiomyopathies. However, the long‐term survival after this surgical procedure may be limited by the patients' condition before the operation.
  • Editor: Oxford, UK: Blackwell Publishing Ltd
  • Idioma: Inglês
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