Reviews Circulatory Support by Cardiomyoplasty and Aortomyoplmasty

The finding that skeletal muscles can be made resistant to fatigue by progressive electrial stimulation has been used as a means of providing circulatory support in cardiac surgery. The first application of this discovery was dynamic cardiomyoplasty, performed for the first time in man in 1985 at the Broussais Hospital. The latissimus dorsi muscle is transposed into the thorax, then attached around the heart and finally stimulated synchronously with the ventricular systole. So far, more than 200 patients in the whole world (including 57 at the Broussais Hospital) have undergone this operation with results that are inreasingly encouraging. In these cases the muscle is used to reinforce or replace the left or right ventricle, but other applications are being studied, such as double cardiomyoplasty (left latissimus dorsi and the right pectoralis major muscles), cardiomyoplasty of the right atrium and aortomyoplasty which produces aortic counterpulsation. The development of these techniques underlines the ever growing interest raised by this type of autologous circulatory support.