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Eur J Cardiothorac Surg 1998;13:213-215
© 1998 Elsevier Science NL

Case report

Preserved skeletal muscle structure with modified electrical stimulation protocol in a cardiomyoplasty patient: a clinico-pathological report

Roberto Lorussoa, Ottavio Alfieria, Ugo Carrarob, Jan J. Schreuderc, Hein J.J. Wellensc

a Cardiac Surgery Division, IIa Divisione Cardiochirurgica, Ospedale Civile, Brescia, 25125, Italy
b Pathology Department, Padua, Italy
c Department of Cardiology, Academic Hospital, Maastricht, The Netherlands

Received 7 August 1997; received in revised form 8 December 1997; accepted 16 December 1997.

Corresponding author. Tel.: +39 30 3995638; fax: +39 30 3995004; e-mail: roberto_lorusso@iol.it

Experimental and clinical studies have recently shown variable degrees of structural abnormalities in the transposed and chronically stimulated muscle graft after cardiomyoplasty procedure. The postoperative stimulation protocol of wrapped skeletal muscle has been claimed to be a major determinant of late structural derangement. Therefore, a modified stimulation protocol had been used after a cardiomyoplasty procedure in a 63-year-old patient. Improved postoperative hemodynamic data could be detected by pressure/volume analysis. After unexpected sudden death occurred at 15 months, autoptic examination showed preserved muscle structure, suggesting that a prudent stimulation protocol may maintain muscle viability and contribute to effective cardiac support.

Key Words: Cardiomyoplasty • Stimulation protocol • Muscle viability




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