New hopes for dynamic cardiomyoplasty from use of Doppler flow wire in evaluation of demand stimulation

J Cardiovasc Surg (Torino). 2002 Feb;43(1):67-70. New hopes for dynamic cardiomyoplasty from use of Doppler flow wire in evaluation of demand stimulation. Rigatelli GL, Carraro U, Barbiero M, Zanchetta M, Rigatelli G. Source Division of Cardiology, Interventional Cardiology LAB and Cardiomyoplasty Project Unit, Legnago General Hospital, Verona, Italy. jackyheart@katamail.com Abstract BACKGROUND: There are no data regarding real cardiac assistance in demand dynamic cardiomyoplasty (DDCMP). A test of the use of Doppler flow wire is presented to demonstrate cardiac assistance in DDCMP. METHODS: Comparative study in hospitalized care. A peripheral Flex Doppler flow wire of 0.018 inch was advanced through a 4F introducer femoral arterial in seven DDCMP patients (age=57.1+/-6.2 years; NYHA= 1.4+/-0.5). A short period of 10 sec with stimulator off and a following period of 15 sec with clinical stimulation were recorded. We measured the maximum peak aortic flow velocity (MPAV) in all beats. Latissimus dorsi (LD) mechanogram was simultaneously recorded. RESULTS: Statistical analysis showed an increase not only in MPAV in assisted period versus rest, but also in assisted beats versus unassisted (8.42+/-6.98% and 7.55+/-3.07%). CONCLUSIONS: Intravascular Doppler proved real systolic assistance in DDCMP; in DDCMP systolic assistance is correlated to the LD wrap speed of contraction, suggesting that demand stimulation could be the most effective protocol in dynamic cardiomyoplasty. PMID: 11803332 [PubMed - indexed for MEDLINE]