| Descending thoracic aortomyoplasty: a technique for clinical application. | |
| | |
MedLine Citation:
|
PMID: 8561646 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Descending thoracic aortomyoplasty is a form of skeletal muscle-powered cardiac assistance. Its use in clinical settings has been limited by the ligation of intercostal arteries necessary to complete a circumferential wrap of the aorta with the latissimus dorsi. METHODS: This study assessed the feasibility and the efficacy of aortomyoplasty constructed with a modified latissimus dorsi. A pericardial patch was attached to the latissimus dorsi and divided around the preserved intercostal arteries. Nine alpine goats (37 +/- 2 kg) underwent descending aortomyoplasty using this technique. All intercostal arteries were preserved. After a 6-week recovery period, the animals underwent a 6-week, incremental electrical conditioning program. After 90 postoperative days, animals were examined under anesthesia with the myostimulator on and off. RESULTS: Aortomyoplasty activation resulted in augmentation of mean diastolic aortic pressure by 16.0 +/- 0.9 mm Hg (23%). Significant improvements in cardiac index (40%), stroke volume index (37%), left ventricular stroke work index (49%), and mean arterial pressure (19%) were noted. An intravascular sonographic probe placed in the descending aorta revealed circumferential compression of the aorta during counterpulsation. Mean cross-sectional aortic area was reduced by 51.8%, from 210.1 +/- 7.1 to 108.9 +/- 6.7 mm2 during aortomyoplasty activation (p < 0.05). Histologic analysis confirmed the long-term patency of intercostal arteries. CONCLUSIONS: Descending aortomyoplasty, modified with an interposing patch of pericardium, effectively transfers skeletal muscle force across the aortic wall and assists cardiac function. This technique allows preservation of all aortic branches, and with this novel approach, the clinical utility of aortomyoplasty can now be explored. |
| | |
Authors:
|
D R Flum; A C Cernaianu; R Meada; L A Lee; K Salartash; M A Grosso; R L Weiss; J H Cilley; A J delRossi |
Related Documents
:
|
15772786 - Coarctation and aorto-aortic bypass: three-dimensional post-processing using multidetec... 22739746 - Time-resolved imaging of contrast kinetics does not improve performance of follow-up mr... 12814066 - Intercostal artery aneurysm complicating aortic coarctation in a 71-year-old-woman. 21821266 - Fifteen-year experience with minimally invasive approach for reoperations involving the... 7629216 - Subaortic left ventricular pseudoaneurysm of obscure origin. 12740246 - Technical aspects of composite arterial grafting with double skeletonized internal thor... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Annals of thoracic surgery Volume: 61 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1996 Jan |
Date Detail:
|
Created Date: 1996-02-23 Completed Date: 1996-02-23 Revised Date: 2010-03-24 |
Medline Journal Info:
|
Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 93-8 Citation Subset: AIM; IM |
Affiliation:
|
Department of Surgery, University of Medicine and Dentistry of New Jersey, Cooper Hospital/University Medical Center, Camden, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Aorta, Thoracic / surgery*, ultrasonography Assisted Circulation* Cardiomyoplasty Electric Stimulation Electrocardiography Goats Hemodynamics Male Muscle, Skeletal / transplantation* Ultrasonography, Interventional |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Serum S100 protein: a potential marker for cerebral events during cardiopulmonary bypass.
Next Document: Mycoplasma hominis infections occurring in cardiovascular surgical patients.