Cardone J C, Yoon P D, Trumble D R, Magovern J A
Division of Thoracic Surgery, Allegheny General Hospital.
Ann Thorac Surg. 1996 Jan;61(1):426-9. doi: 10.1016/0003-4975(95)01006-8.
Aortomyoplasty is a technique for achieving autogenous diastolic counterpulsation. This experiment was designed to determine if aortomyoplasty using conditioned latissimus dorsi muscle could improve regional myocardial function during coronary ischemia.
Six mongrel dogs underwent a staged operation in which the left latissimus dorsi was conditioned in situ for 4 weeks, then wrapped around the descending aorta and stimulated during diastole with each cardiac contraction. Regional ischemia was caused by occlusion of the left anterior descending coronary artery. Regional function was measured with somomicrometry in the region of ischemia and in a control area. An intraaortic balloon pump was inserted for comparison with aortomyoplasty performance.
Coronary artery occlusion caused a significant decrease in the percentage of regional shortening (14.2 +/- 7.9 to -2.2 +/- 4.0; p = 0.001) and thickening (11.9 +/- 4.6 to -5.8 +/- 3.3; p < 0.001). Aortomyoplasty improved regional motion in both percentage shortening (-2.2 +/- 4.0 to 2.3 +/- 3.7; p = 0.008) and thickening (-5.8 +/- 3.3 to 2.8 +/- 1.9; p < 0.001). The intraaortic balloon pump also improved percentage shortening (-3.7 +/- 2.0 to 0.7 +/- 1.9; p = 0.01) and thickening (-5.0 +/- 2.8 to 2.4 +/- 3.8; p < 0.001), and was not significantly different than aortomyoplasty.
These data show that aortomyoplasty has beneficial effects on ischemic left ventricular contractility, and may therefore be useful for treating inoperable coronary artery disease.
主动脉成形术是一种实现自体舒张期反搏的技术。本实验旨在确定使用经预处理的背阔肌进行主动脉成形术是否能改善冠状动脉缺血期间的局部心肌功能。
对6只杂种犬进行分期手术，其中左背阔肌在原位预处理4周，然后包裹在降主动脉周围，并在舒张期随每次心脏收缩进行刺激。通过结扎左前降支冠状动脉造成局部缺血。用体视显微镜测量缺血区域和对照区域的局部功能。插入主动脉内球囊泵以与主动脉成形术的效果进行比较。
冠状动脉结扎导致局部缩短百分比显著降低（从14.2±7.9降至-2.2±4.0；p = 0.001）和增厚百分比显著降低（从11.9±4.6降至-5.8±3.3；p < 0.001）。主动脉成形术改善了局部运动，无论是缩短百分比（从-2.2±4.0提高到2.3±3.7；p = 0.008）还是增厚百分比（从-5.8±3.3提高到2.8±1.9；p < 0.001）。主动脉内球囊泵也改善了缩短百分比（从-3.7±2.0提高到0.7±1.9；p = 0.01）和增厚百分比（从-5.0±2.8提高到2.4±3.8；p < 0.001），且与主动脉成形术无显著差异。
这些数据表明，主动脉成形术对缺血性左心室收缩性有有益影响，因此可能有助于治疗无法手术的冠状动脉疾病。
