Cardiomyoplasty as an Alternative for Heart Transplant Patients

Abstract

The use of cardiac transplantation is effective but limited by the availability of donors as well as contraindications to transplantation. Dynamic cardiomyoplasty provides an alternative to cardiac transplantation or medical management in patients with poor cardiac function. The goal of dynamic cardiomyoplasty is to augment cardiac function by wrapping a skeletal muscle around the heart and stimulating it to contract in synchrony with heart contractions. The striated muscle is trained postoperatively to contract when stimulated. An internal pacing device coordinates contraction to improve cardiac output and decrease heart workload. Cardiomyoplasty provides improved cardiac function without prohibiting future transplant and therefore offers a significant advantage to this patient population. Long-term follow-up studies have demonstrated that postoperatively, patients have improved New York Heart Association functional class and prolonged and improved quality of life.