Clinical Experience with Dynamic Cardiomyoplasty

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Abstract
Dynamic cardiomyoplasty using the latissimus dorsi muscle graft (LDMG) was applied to 11 patients with dilated cardiomyopathy of different etiologies. Our first case was operated on July 1987. All patients were in Functional Class (FC) IV New York Heart Association (NYHA) and had multiple previous admissions in intensive care units for intractable cardiac insufficiency. Two patients died during the procedure, the perioperative mortality was 18%. One patient died of recurrent acute myocarditis at the fourth postoperative month and a second patient died in the sixteenth postoperative month. Both patients were asymptomatic, in FC I-II, and the cause of death was sudden arrhythmia (ventricular fibrillation). The remaining seven patients (63.6%) were in FC I-II and the longest follow-up was 30 months. In all patients, the ejection fraction (EF) by radioisotopic ventriculography improved an average of 50% as well as their ergometric test. Dynamic cardiomyoplasty appears to be a satisfactory alternative for the treatment of patients with severe cardiac insufficiency secondary to dilated cardiomyopathy. Its main advantage seems to be a significant improvement in the quality of life for these patients.