| 摘要 |
Heart failure may be treated by grafting a skeletal muscle around the heart in a procedure called cardiomyoplasty. The muscle graft is stimulated to contract in synchrony with the heart by a burst stimulator, and the procedure has been shown to have some benefits. However, the operative and early mortality is high (nearly 50% 2-year mortality). The present invention recognizes a fundamental limitation to the effectiveness of cardiomyoplasty when applied to a markedly enlarged heart, due to the length tension characteristics of muscle. A two-stage procedure is provided, whereby the enlarged heart is first treated with a mechanical cardiac assist pump to reduce it to near normal size. Then a second surgical procedure, in which an optimal length of muscle is grafted to the heart, is performed about 4-6 weeks later. The muscle to be grafted may be preconditioned by electrical stimulation within a pouch designed to prevent tissue adhesions, during the time that the heart is being reduced in size with mechanical assistance. |
