Chaudhry P A, Mishima T, Sharov V G, Hawkins J, Alferness C, Paone G, Sabbah H N
Department of Medicine and Surgery, Henry Ford Heart and Vascular Institute, Henry Ford Health System, Detroit, Michigan, USA.
Ann Thorac Surg. 2000 Oct;70(4):1275-80. doi: 10.1016/s0003-4975(00)01755-0.
We examined the effects of passive containment of the cardiac ventricles with a surgically placed epicardial prosthetic wrap on indexes of left ventricular (LV) remodeling in dogs with heart failure.
Heart failure (LV ejection fraction 30% to 40%) was produced in 12 dogs by intracoronary microembolization. Six dogs underwent mid-sternotomy and pericardiotomy with placement of a preformed-knitted polyester device (Acorn Cardiac Support Device [CSD], Acorn Cardiovascular, Inc, St. Paul, MN) snugly around the ventricles and anchored to the atrioventricular groove. Six dogs did not undergo surgery and served as controls. Dogs were followed for 3 months prior to sacrifice.
In controls, LV end-diastolic volume increased after 3 months (67 +/- 12 versus 83 +/- 8 ml; p = 0.04), while in CSD-treated dogs, it decreased (68 +/- 10 versus 61 +/- 10 ml; p = 0.002). CSD-containment of LV size was associated with increased LV systolic fractional area of shortening, while in controls, fractional area of shortening decreased. CSD-treated dogs also showed amelioration of myocyte hypertrophy and attenuation of interstitial fibrosis compared to controls.
In dogs with heart failure, passive epicardial containment of the ventricles with the Acorn CSD ameliorates LV remodeling and improves LV systolic function.
我们研究了通过手术放置的心外膜人工包裹物对心力衰竭犬左心室（LV）重构指标进行被动心室包裹的效果。
通过冠状动脉内微栓塞法使12只犬产生心力衰竭（左心室射血分数30%至40%）。6只犬接受胸骨正中切开术和心包切开术，将预制编织聚酯装置（橡果心脏支持装置[CSD]，橡果心血管公司，明尼苏达州圣保罗）紧密环绕心室并固定于房室沟。6只犬未接受手术作为对照。在处死前对犬进行3个月的随访。
在对照组中，3个月后左心室舒张末期容积增加（67±12对83±8 ml；p = 0.04），而在接受CSD治疗的犬中，其容积减小（68±10对61±10 ml；p = 0.002）。CSD对左心室大小的包裹与左心室收缩期缩短分数面积增加相关，而在对照组中，缩短分数面积减小。与对照组相比，接受CSD治疗的犬还表现出心肌细胞肥大改善和间质纤维化减轻。
在心力衰竭犬中，使用橡果CSD对心室进行被动心外膜包裹可改善左心室重构并提高左心室收缩功能。
