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A Review of the Concept of Circulatory Bioassist Focused on the "New" Demand Dynamic Cardiomyoplasty: The Renewal of Dynamic Cardiomyoplasty?

Cardiomyoplasty Project Unit, Legnago General Hospital, Verona; Department of Biomedical Science, University of Padua, Padua Medical School, Padua; and Montescano Medical Center, Fondazione Maugeri, Montescano, Pavia, Italy.

Ugo Carraro, MD

Department of Biomedical Science, University of Padua, Padua Medical School, Padua.

Mario Barbiero, MD

Cardiomyoplasty Project Unit, Legnago General Hospital, Verona; Department of Biomedical Science, University of Padua, Padua Medical School, Padua; and Montescano Medical Center, Fondazione Maugeri, Montescano, Pavia, Italy.

Roberto Riccardi, MD

Montescano Medical Center, Fondazione Maugeri, Montescano, Pavia, Italy.

Franco Cobelli, MD

Montescano Medical Center, Fondazione Maugeri, Montescano, Pavia, Italy.

Marzio Gemelli, MD

Cardiomyoplasty Project Unit, Legnago General Hospital, Verona; Department of Biomedical Science, University of Padua, Padua Medical School, Padua; and Montescano Medical Center, Fondazione Maugeri, Montescano, Pavia, Italy.

Giorgio Rigatelli, MD, FACA

Cardiomyoplasty Project Unit, Legnago General Hospital, Verona; Department of Biomedical Science, University of Padua, Padua Medical School, Padua; and Montescano Medical Center, Fondazione Maugeri, Montescano, Pavia, Italy.

After the initial enthusiasm, the dynamic cardiomyoplasty lost its reputation owing to the poor long-term results, caused by the muscular degeneration subsequent to chronic continuous electrical stimulation of the latissimus dorsi. An activity-rest stimulation protocol that avoids full transformation of the skeletal muscle, maintaining muscular properties over time, has been successfully tried. This "demand" stimulation protocol showed in humans good results improving NYHA class, ejection fraction value, and survival. The discussion about the capa bility of this and a unique kind of cardiocirculatory bioassist is due to be reopened. In fact, heart transplant, percutaneous circulatory-supporting device, multisites stimulation therapy, and total artificial heart have some drawbacks, one of which is the economic cost. In developing countries the more economic demand dynamic cardiomyoplasty may still play a role.

Angiology, Vol. 54, No. 3, 301-306 (2003)
DOI: 10.1177/000331970305400305


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