An engineering model of dynamic cardiomyoplasty. II. Clinical applications.

Abstract

Previously, a modification to the Sunagawa engineering model for the isolated left ventricle and arterial system was proposed and validated for dynamic cardiomyoplasty in an acute goat preparation. To test the hypothesis that this model may be applied to the clinical scenario in cardiomyoplasty patients, we predicted human stroke volume using the model with human clinical data from the literature. Predicted stroke volume correlated well with published stroke volume in patients who have had the dynamic cardiomyoplasty procedure. These results suggest that the modest hemodynamic improvement commonly reported after the procedure is performed may be due to diminished latissimus dorsi strength after transformation. The validity of both the original Sunagawa model and the previously proposed modification for dynamic cardiomyoplasty is further supported with these results. A nomogram methodology for predicting stroke volume after dynamic cardiomyoplasty for any particular patient is presented.