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J Thorac Cardiovasc Surg 2009;137:e58-e59
© 2009 The American Association for Thoracic Surgery

Brief Communication

Demand dynamic biogirdling: Ten-year results

^a C.N.R. Institute of Neuroscience, Unit for Neuromuscularbiology and Physiopathology, Laboratory of Applied Myology of the Department of Biomedical Science, University of Padua, Padua Medical School, Padua, Italy
^b Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy
^c Fondazione Maugeri, Montescano, Pavia, Italy
^d Department of Specialistic Medicine, Division of Cardiology, Legnago General Hospital, Verona, Italy

Received for publication March 2, 2008; accepted for publication June 1, 2008.

^_* Address for reprints: Gianluca Rigatelli, MD, FACP, FACC, FESC, FSCAI, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy, Via WA Mozart, 9 37040 Legnago, Verona, Italy. (Email: jackyheart@hotmail.com).

The first 20% of the full text of this article appears below.

Questionable systolic assistance and latissimus dorsi (LD) degeneration have been considered the main drawbacks of dynamic cardiomyoplasty since its creation by Carpentier and Chachques.¹ With the hope of improving systolic assistance and reducing muscular damage, fewer impulses per day were delivered than with the standard clinical stimulation protocol. This was achieved by providing the LD wrap with daily periods of rest (demand stimulation) on the basis of a heart rate cutoff.² We present the results after 10 years of demand dynamic biogirdling (DDBG) in Italy.

Methods

We retrospectively reviewed clinical, echocardiographic, mechanographic, and cardiac invasive assessment records of 14 patients (13 men, 1 woman, mean age 58.3 ± 5.7 years, sinus rhythm n = 12, atrial fibrillation n = 2) with idiopathic dilated cardiomyopathy and congestive heart failure who underwent dynamic cardiomyoplasty from 1993 to 1996 according to the protocol of Carpentier and Chachques.¹ Informed consent was obtained from all patients.

The demand stimulation protocol was introduced in the hope of avoiding complete LD wrap transformation caused by the continuous stimulation protocol of the US Food and Drug Administration phase 2 trial used by the American Cardiomyoplasty Group.³ It is well known that a muscle that has been fully transformed by continuous stimulation displays significant loss of power, generally attributed to fiber type change or to the loss of type 2 myofibers (fast-contracting myofibers). The inclusion of daily . . . [Full Text of this Article]

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				J. C Chachques, O. Jegaden, T. Mesana, Y. Glock, P. A Grandjean, and A. F Carpentier Cardiac Bioassist: Results of the French Multicenter Cardiomyoplasty Study Asian Cardiovasc Thorac Ann, December 1, 2009; 17(6): 573 - 580. [Abstract] [Full Text] [PDF]