Cardiomyoplasty: treatment of the failing heart using the skeletal muscle wrap

Abstract

Surgical methods of augmenting cardiac function are gaining credibility among researchers as animal and human clinical trials continue around the world. The procedures themselves may vary slightly depending upon protocol and surgeon preference, but generally involve the use of skeletal muscle such as the latissimus dorsi. The muscle may be wrapped around the heart or the aorta, or fashioned into a separate pumping chamber. The muscle is then stimulated with specialized burst pacing, the resultant contractions providing circulatory support. This article describes preoperative, intraoperative, postoperative, and follow-up patient and family care for those undergoing skeletal muscle wrap procedures. If trials continue to produce positive results, these interventions may become an important bridge to transplant. Moreover, with the scarcity of donor hearts, the implications for skeletal muscle wrapping as a long-term alternative to transplant are promising.