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  • Title: New hopes for dynamic cardiomyoplasty from use of Doppler flow wire in evaluation of demand stimulation.
    Author: Rigatelli GL, Carraro U, Barbiero M, Zanchetta M, Rigatelli G.
    Journal: J Cardiovasc Surg (Torino); 2002 Feb; 43(1):67-70. PubMed ID: 11803332.
    Abstract:
    BACKGROUND: There are no data regarding real cardiac assistance in demand dynamic cardiomyoplasty (DDCMP). A test of the use of Doppler flow wire is presented to demonstrate cardiac assistance in DDCMP. METHODS: Comparative study in hospitalized care. A peripheral Flex Doppler flow wire of 0.018 inch was advanced through a 4F introducer femoral arterial in seven DDCMP patients (age=57.1+/-6.2 years; NYHA= 1.4+/-0.5). A short period of 10 sec with stimulator off and a following period of 15 sec with clinical stimulation were recorded. We measured the maximum peak aortic flow velocity (MPAV) in all beats. Latissimus dorsi (LD) mechanogram was simultaneously recorded. RESULTS: Statistical analysis showed an increase not only in MPAV in assisted period versus rest, but also in assisted beats versus unassisted (8.42+/-6.98% and 7.55+/-3.07%). CONCLUSIONS: Intravascular Doppler proved real systolic assistance in DDCMP; in DDCMP systolic assistance is correlated to the LD wrap speed of contraction, suggesting that demand stimulation could be the most effective protocol in dynamic cardiomyoplasty.
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