Document Detail


Ventricular constraint in dilated cardiomyopathy: a new, compliant textile mesh exerts prophylactic and therapeutic properties.
MedLine Citation:
PMID:  16214527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dilated cardiomyopathy is associated with a progressive decrease in cardiac function, leading to end-stage heart failure. We aimed to stop this process by mechanically constraining the heart with a new, compliant textile mesh. METHODS: In 16 male Munich minipigs (50 +/- 7 kg), dilated cardiomyopathy with congestive heart failure was induced through 4 weeks of rapid ventricular pacing (220 beats/min). In the early-mesh group (n = 8), a polyvinylidene fluoride mesh was positioned around both ventricles before pacing was started. In the other group (n = 8), experimental dilated cardiomyopathy through rapid pacing was induced (no mesh). After mesh grafting, rapid pacing was continued (late mesh). RESULTS: Rapid pacing in the no-mesh group (control group) significantly decreased both systolic (cardiac output, peak systolic pressure, and the derivative of pressure increase [dP/dt(max)]) and diastolic (minimum rate of pressure rise [dP/dt(min)] and left ventricular end-diastolic pressure) variables, whereas these variables remained almost unchanged in the early-mesh group. In the late-mesh group the passive-elastic constraint not only prevented further deterioration but even exerted reverse remodeling to some extent (dP/dt(max) and left ventricular end-diastolic pressure, P < .05). CONCLUSIONS: Ventricular constraint with the new mesh seems to be a prophylactic and therapeutic option in cardiac insufficiency caused by ventricular dilation. This passive-elastic cardioplasty induced reverse remodeling of dilated hearts and significantly improved diastolic and systolic ventricular function.
Authors:
P Feindt; U Boeken; J D Schipke; J Litmathe; N Zimmermann; E Gams
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  130     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-10     Completed Date:  2005-12-22     Revised Date:  2007-09-05    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1107     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Heinrich-Heine-University Hospital Duesseldorf, Germany.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiomyopathy, Dilated / prevention & control*,  surgery*
Heart Ventricles
Male
Surgical Mesh*
Swine
Swine, Miniature
Comments/Corrections
Erratum In:
J Thorac Cardiovasc Surg. 2007 Sep;134(3):A34

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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