Dynamic Cardiomyoplasty: Dead or Alive?

The dynamic cardiomyoplasty provide an active girdle effect by the wrap of the electrostimulated left latissimus dorsi muscle around the heart. The technique has been almost abandoned in the last five years because the chronic continuous electrical stimulation degenerates the muscle, lowering the long-term results of the intervention. An activity-rest stimulation protocol, which avoid full transformation of the skeletal muscle, maintaining muscular properties overtime, has been proposed showing in humans good results in term of NYHA class, EF and survival improvement. The debate about the capability of this unique kind of cardiocirculatory bio-assist is virtually open: the economic and cost-saving demand dynamic cardiomyoplasty avoiding immunosuppression therapy, extracorporeal circulation equipment and expensive follow-up, probably will be still alive.