A new method of double cardiomyoplasty: “contractile muscular sling”

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A new method of double cardiomyoplasty: “contractile muscular sling” Hidetoshi Furuta, MD, Go Watanabe, MD, Takuro Misaki, MD, Katsushi Ueyama, MD The Annals of Thoracic Surgery Volume 67, Issue 5, Pages 1339-1344 (May 1999) DOI: 10.1016/S0003-4975(99)00180-0

Fig 1 Our method of double cardiomyoplasty. Both latissimus dorsi muscles (LDM) are crossed in front of the heart and then wrapped around it, the left latissimus dorsi going counterclockwise and the right, clockwise. Then the two muscles are sutured to each other behind the heart, thereby forming a “sling”. When this sling contracts, the force vector is directed toward the center of the sling. The Annals of Thoracic Surgery 1999 67, 1339-1344DOI: (10.1016/S0003-4975(99)00180-0)

Fig 2 Pressure tracings with synchronous burst stimulation of both latissimus dorsi muscles after propranolol-induced heart failure. The solid arrow shows a point of starting stimulation. The asterisk shows assisted beat. (AoF = aortic flow; AoP = aortic pressure; CVP = central venous pressure; PAP = pulmonary artery pressure.) The Annals of Thoracic Surgery 1999 67, 1339-1344DOI: (10.1016/S0003-4975(99)00180-0)

Fig 3 Pressure–volume loops. The slope of end-systolic elastance and stroke volume increased with double cardiomyoplasty (CMP). The Annals of Thoracic Surgery 1999 67, 1339-1344DOI: (10.1016/S0003-4975(99)00180-0)

Fig 4 Hemodynamic changes with double cardiomyoplasty (DCMP): aortic pressure (AoP) (upper = systolic and lower = diastolic); pulmonary artery pressure (PAP) (upper = systolic and lower = diastolic); end-systolic elastance (Ees); arterial elastance (Ea); end-diastolic pressure (EDP); cardiac output (CO); and stroke volume (SV). (NS = not significant.) The Annals of Thoracic Surgery 1999 67, 1339-1344DOI: (10.1016/S0003-4975(99)00180-0)

Fig 5 Hemodynamic changes with single cardiomyoplasty (SCMP); aortic pressure (AoP) (upper = systolic and lower = diastolic); pulmonary artery pressure (PAP) (upper = systolic and lower = diastolic); end-systolic elastance (Ees); arterial elastance (Ea); end-diastolic pressure (EDP); cardiac output (CO); and stroke volume (SV). (NS = not significant.) The Annals of Thoracic Surgery 1999 67, 1339-1344DOI: (10.1016/S0003-4975(99)00180-0)