Cardiomyoplasty: Procedure, pre, and post-operative care
Cardiomyoplasty is a new surgical intervention, where skeletal muscle especially latissmus Dorsi muscle is transformed to be reinforced for the myocardium. A special pacemaker is implanted to the skeletal muscle which helps it to contract. Cardiomyoplasty is related to damaged myocardium remodeling. It a bio medical approach to reconstruct, repair and improve biological tissue.
If the procedure of cardiomyoplasty is successful and the cardiac output is achieved, then it works as a bridging therapy and proving time for the myocardium to be treated by some other ways.
When is it required?
Cardiomyoplasty is a complex procedure and is performed for the following conditions:
- Congestive cardiac failure: It is one of the most common causes of hospitalization and death of people in a developed nation. A heart transplant is the most viable solution for this condition but there is a scarcity of donors.
- Coronary artery disease in an advanced stage.
Types of cardiomyoplasty:
There are two types of cardiomyoplasty
- Cellular cardiomyoplasty: In this type of cardiomyoplasty cells are grown in the diseased heart. The progenitor cells are used to repair the damaged heart cells.
- Dynamic cardiomyoplasty: In this type of cardiomyoplasty skeletal muscles are transformed to reinforce them to act as myocardial cells. A pacemaker is also attached to help the heart contract.
Cardiomyoplasty: Pre operative care:
There is a lack of donors still people look forward to heart transplant; cardiomyoplasty is a much safer and viable procedure. before cardiomyoplasty, the patient must undergo the following test:
- 2-D ECO
- ECG
- Stress test with thallium scan
- Measurement of maximum oxygen consumption
- Peak heart rate
- Blood pressure must be controlled
- Weight must be maintained
- CT scan of the chest to ensure the thickness of latissmus dorsi
- To be sure there is pathology involving chest
Surgical procedure:
The dynamic cardiomyoplasty is done in two phases.
In the first phase, the latissmus Dorsi muscle is immobilized from the chest wall. Care is taken to keep the subcutaneous tissue and nerve bundle intact. Two intramuscular stimulating lead is attached to the latissmus dorsi and is attached to the muscles of bundle origin at right angles.
In the second phase after a few days, the latissmus dorsi is detached from its origin and insertion and is wrapped around the heart.
The whole surgical procedure is done under the effects of anesthesia.
Postoperative care
- Physical exercises must be avoided until complete recovery
- Care must be taken to avoid infection around the site of incision
- Fluid intake must be increased
- Smoking should be avoided
- Alcohol consumption must be limited
- No stress should be taken
- Eating healthy and balanced foods
Is this surgery safe?
The surgery is a safe surgery it avoids conditions like immunosuppression, thromboembolism, infection, and lack of donors. Although it is up to the doctor to suggest this surgery as there are few contra-indicators for this surgery which are:
- People suffering from diabetes
- People suffering from liver failure
- People suffering from renal failure
- People suffering from pulmonary dysfunction
This surgery is advisable to the aged person too.
When to see a doctor post operation
One should see a doctor post operation if they experience the following symptoms:
- Chest pain
- Fever
- Pus around the site of incision
- Signs of inflammation around the site of incision
- Shortness of breath
- Bluish discoloration of the skin and mucous membrane, especially tip of nose, lips, and tops of fingers.