Cardiomyoplasty, in spite of recent improvements, remains a high risk operation. The early postoperative period is sometimes very critical, even for patients selected from preoperative New York Heart Association functional class IV. During the surgical period, poor hemodynamics may be responsible for early death, as well as influence latissimus dorsi muscle long-term viability. Circulatory assist, including pharmacologic support with enoximone, intraaortic balloon counterpulsation (IABP), and ventricular assist devices (VAD), may be needed. From February, 1993 to September, 1994, 14 clinical dynamic cardiomyoplasty procedures were performed using the Medtronic (Minneapolis, MN) system at Hôpital La Timone, Marseille, France. Eight patients suffered from early and severe postoperative heart failure. Enoximone was used in three patients and IABP in five patients. Two days after cardiomyoplasty, one of the IABP patients required an implantable left VAD (Thermocardio Systems, Woburn, MA) as a bridge to cardiac transplantation. Overall hospital mortality was 7%. The authors studied the preoperative clinical data and surgical techniques to find specific risk factors that could have influenced postoperative events. Another aim of this study was to evaluate long-term benefits in these particular patients. Results showed that cardiomyoplasty patients may require complex means to overcome postoperative hemodynamic failure, but without necessarily poor long-term results. This should be an important step in improving future patient selection.

Adult↗

PubMedDate not supplied

[The fate of children who have undergone correction of Fallot's tetralogy. Report of fifty long term assessments (author's transl)].

50 children who had beneficied of repair of Fallot's tetralogy with a follow up of 2 to 11 years, were psychologicaly and physicaly evaluated. Work capacity tests were performed in 12 cases. Children with early repair (before 5 years of age) have a very better result. Preliminary palliative treatment cause worse results. Physical capacities are normal in the majority of children. Work capacity is not different from normal children. Repair before school age is the best way for a normal life.

Achievement↗