Key result
Dynamic cardiomyoplasty in patients with severe chronic heart failure resulted in clinical improvement in 88% of patients, with a hospital mortality rate of 14%.
Why the study?
Does dynamic cardiomyoplasty improve long-term survival and functional outcomes in patients with chronic heart failure despite maximal pharmacological therapy?
Observational (n=212)
Yes
Does dynamic cardiomyoplasty improve long-term survival and functional outcomes in patients with chronic heart failure despite maximal pharmacological therapy?
Dynamic cardiomyoplasty provides clinical improvement in the majority of patients with refractory heart failure, serving as a potential destination therapy or bridge to transplantation despite significant perioperative and late mortality.
The French multicenter experience (6 centers) of dynamic cardiomyoplasty was analyzed for long-term survival and functional outcome, the most important endpoints in congestive heart failure therapy. Cardiomyoplasty was performed in 212 patients with symptoms of chronic heart failure despite maximal pharmacological therapy. The etiology was ischemic (48%), idiopathic (45%) or other (7%). Cardiomyoplasty was performed using the latissimus dorsi muscle which was electrostimulated after surgery. During follow-up, 88% of patients improved clinically. Hospital death occurred in 29 (14%) patients and was related to the severity of preoperative heart failure symptoms. Late mortality occurred in 99 patients due to heart failure (44%), sudden death (37%), or noncardiac causes (18%). Combined dynamic cardiomyoplasty and implantation of a cardiac rhythm management system was safely achieved in 22 patients, and 26 underwent heart transplantation for recurrent heart failure. Long-term functional improvements were observed in most patients, and the best outcome was achieved in those with isolated right ventricular failure. Dynamic cardiomyoplasty can be considered as a destination therapy or a mid- to long-term biological bridge to heart transplantation.
No takes yet. Share an insight, caveat, or question.
Chachques et al. (2009) conducted an observational in chronic heart failure (n=212). Dynamic cardiomyoplasty was evaluated on long-term survival and functional outcome. Dynamic cardiomyoplasty in patients with severe chronic heart failure resulted in clinical improvement in 88% of patients, with a hospital mortality rate of 14%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:
More on Cardiac device therapyMore from Asian Cardiovascular and Thoracic Annals