Vascular delay of the latissimus dorsi provides an early hemodynamic benefit in dynamic cardiomyoplasty Ahsan T Ali, MD, William P Santamore, PhD, Ben.

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Presentation transcript:

Vascular delay of the latissimus dorsi provides an early hemodynamic benefit in dynamic cardiomyoplasty Ahsan T Ali, MD, William P Santamore, PhD, Ben Y Chiang, MD, Robert D Dowling, MD, Gordon R Tobin, MD, A.David Slater, MD The Annals of Thoracic Surgery Volume 67, Issue 5, Pages 1304-1311 (May 1999) DOI: 10.1016/S0003-4975(99)00186-1

Fig 1 Each intervention plotted on a time chart. Day zero represents the time when vascular delay was performed on groups VD and VDES. (CMP) Cardiomyoplasty. (Stim) muscle stimulation was commenced in group ES and VDES on the second postoperative day. Each group was evaluated 2 weeks after cardiomyoplasty. Microspheres were given at the time of final evaluation. The Annals of Thoracic Surgery 1999 67, 1304-1311DOI: (10.1016/S0003-4975(99)00186-1)

Fig 2 Typical data trace for dog in group ES: aortic pressure (AOP), LV pressure (LVP), aortic flow, dP/dt, and ECG. Every fifth beat is stimulated as observed on the ECG. No increase in any hemodynamic parameter is observed for stimulated beats (st). The Annals of Thoracic Surgery 1999 67, 1304-1311DOI: (10.1016/S0003-4975(99)00186-1)

Fig 3 Typical data trace for a dog in group VDES: aortic pressure (AOP), LV pressure (LVP), aortic flow, dP/dt, and ECG. Marked improvement for all stimulated beats vs nonstimulated. The Annals of Thoracic Surgery 1999 67, 1304-1311DOI: (10.1016/S0003-4975(99)00186-1)

Fig 4 Increase in peak LV pressure (Δ LVP in mm Hg) for stimulated beats in groups: VDES (24.5), VD (20.6), ES (2.4), and control (10.5). Note that VD and VDES are significantly higher than control and ES. ∗p < 0.01 control or ES compared with VD or VDES. The Annals of Thoracic Surgery 1999 67, 1304-1311DOI: (10.1016/S0003-4975(99)00186-1)

Fig 5 Increase in peak aortic pressures (Δ AOP) with LDM stimulation for all groups. ∗VDES and VD are significantly higher than both ES (p < 0.01) and controls (p < 0.01). The Annals of Thoracic Surgery 1999 67, 1304-1311DOI: (10.1016/S0003-4975(99)00186-1)

Fig 6 Increase in stroke volume (Δ SV) for all groups with LDM stimulation. ∗Δ SV is higher for both VDES and VD when compared with ES (p < 0.01). (Caret) Δ SV is higher for VD compared with control. The Annals of Thoracic Surgery 1999 67, 1304-1311DOI: (10.1016/S0003-4975(99)00186-1)

Fig 7 Increase in stroke work (Δ SW) for all groups with LDM-assisted beats. ∗Δ SW is significantly higher for groups VDES (7.6 ± 0.8) and VD (8.5 ± 0.7) compared with ES (2.1 ± 1.1) (p < 0.01). (Caret) Δ SW is significantly higher for VD compared with controls (p < 0.05). The Annals of Thoracic Surgery 1999 67, 1304-1311DOI: (10.1016/S0003-4975(99)00186-1)

Fig 8 Increase in maximum and minimum ± dP/dt for all groups with LDM stimulation. ∗Δ + dP/dt is higher for VDES compared with control and ES. (∧)Δ-Negative dP/dt is significantly lower for VDES compared with controls. The Annals of Thoracic Surgery 1999 67, 1304-1311DOI: (10.1016/S0003-4975(99)00186-1)