A Clinical-pathological Study 2 Years Following Cardiomyoplasty: Intact Latissimus Dorsi Muscle and Metabolic Tranformation of

A young patient died suddenly 2 years after cardiomyoplasty.The anatomo-pathological study showed cardiomegaly and confirmed a classic dilated cardiomyopathy. The Latissimus dorsi muscle (LDM) covered both ventricles and hard adhesions between epicardium and epimisium were seen. The electrodes remained in the original position. Some interstitial fibrosis and fiber atrophy and degeneration, were observed around the electrodes. Histological and enzyme-histochemical studies showed that the muscle morphology of the LDM flap stimulated up to 2 years was well preserved. Morphological changes seen in some fibers were isolated on occasional events. Also in the present case, muscle fiber transformation into fatigue resistant, oxidative type 1 fibers was almost complete after the long-term electric stimulation. Key words: cardiomyoplasty, Latissimus dorsi muscle, fibers transformation. Basic Appl Myol 7 (6): 369-373, 1997 Dynamic cardiomyoplasty is a surgical method based upon the use of conditioned Latissimus Dorsi Muscle (LDM) for reinforcement of the cardiac ventricular wall. A program of chronic electrical stimulation of the muscle evokes an adaptive remodelling of the contractile apparatus of the muscle fibers and provides long-term cardiac assistance [7, 13, 19, 21]. In selected patients with chronic heart failure the method is considered a reliable alternative to heart transplantation [1, 16]. Post mortem studies on LDM utilised for cardiomyoplasty have recently been performed on 3 patients who deceased suddenly 15 months, 2 and 8 years after cardiomyoplasty [3, 5, 13, 23]. These studies generally indicated a sufficient preservation of histological characteristics of LDM and an enzyme-histochemical "plastic" reorganisation of fiber types after electric stimulation protocol. Additional LDM morphology findings of long-term dynamic Cardiomyoplasty patients at autopsy related to each patients clinical outcome has been recently reporte