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Giới thiệu động cardiomyoplasty (DCMP) trong giai đoạn cuối cùng của thử nghiệm lâm sàng để đánh giá nó như là một giải pháp thay thế phẫu thuật cho việc quản lý của suy tim giai đoạn cuối. Thủ tục này là khái niệm dựa trên truyền đạt lực co của cơ xương của bệnh nhân để thực hiện những hỗ trợ tim. | 8. Dynamic cardiomyoplasty Vinay Badhwar David Francischelli and Ray C-J. Chiu Introduction Dynamic cardiomyoplasty DCMP is in the final stages of a clinical trial to evaluate it as a surgical alternative for the management of end-stage heart failure. This procedure is conceptually based upon imparting the contractile force of the patient s own skeletal muscle to perform cardiac assistance. It is accomplished by wrapping the latissimus dorsi muscle LDM around the failing heart and by means of an implantable cardiomyostimulator stimulating the muscle to contract in synchrony with cardiac systole. DCMP has been proposed as an alternative and bridge to transplantation in selected patients. Compared with other surgical options in heart failure this approach has a number of advantages. Cardiomyoplasty obviates the donor organ dependency and immunosuppression of transplantation. This totally implantable form of biomechanical assist also avoids the power constraints and thromboembolic risks experienced with mechanical assist devices. The LDM can be utilized with little or no loss of shoulder function and the DCMP procedure itself costs significantly less than other surgical options for the treatment of heart failure. This chapter will outline the historical progress and biologic basis for skeletal muscle powered assist delve into the physiologic mechanisms of DCMP and summarize the techniques and current clinical experience with DCMP. Future perspectives on DCMP and other forms of biomechanical cardiac assist will also be discussed. Historical Development The idea of using skeletal muscle to augment cardiac function was introduced in the 1930s when a muscle graft was used to repaứ traumatic ventricle defects.12 Some early clinicians attempted to use the vascularity of a muscle graft as a source of exogenous myocardial blood supply.3 5 It was not until 1959 that the notion of utilizing stimulated skeletal muscle as a means of cardiac assistance was introduced by Kantrowitz
