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Ventricular Wrap

Posted by Tim on July 18, 1999 at 09:07:24
A friend was just diagnosed with cardiomyopathy.  After a complete work-up, it was determined that his left ventrical is enlarged (all other systems of the body were not affected).  He has a 25% refraction.  He is on the donor heart transplant list.  My question is about a procedure called a ventricular wrap (layman's name I'm sure).  As of yet, I have not been able to locate information concerning this procedure and its success rate.  Would it be possible to provide additional iformation about the ventricular wrap (including its medical procedure name) and any related websites.  Thank you very much.

Posted by Mario on July 18, 1999 at 11:32:07
Hi Tim  I am sure what you are reffering to is "Cardiomyoplasty". This is an option used for end stage heart failure patients, best for class 111 patients. The patients own latissimus dorsi muscle (back muscle) is wrapped around the heart and is stimulated in synchrony with the heart muscle( They will beat in unison).The back muscle once in place can be converted from "fatiquing" to "fatique resistant" muscle. So don't worry your friend won't have any muscle heartache from the muscle's constant beating. This will help the heart by increasing systolic function, he will now have that extra punch to his beat to help the heart pump out the blood. Make sure the center has the experience to preform this procedure. Experienced centers are having good results however mortality is increased for patients with class 1V heart failure, heart sizes greater than 80mm, severe mitral regurgitation, atrial fibrillation or any ventrical arrhythmias. If the patient is a class 111 heart failure case some journals mention that a 1.4 class improvement is possible. At a 3 month follow up mortality is <10%. I hope I am not steering you wrong and I am not a doctor, the staff doctors will correct any wrong info I am passing on to you. P.S I don' recall how many years ago but I do recall that an old episode of Chicago Hope touched on this subject. It was not very technical but brought the point across. You could propably contact the Chicago Hope Producers and they might be able to help you locate that episode if only to have the patient see it on t.v.  Hope to have helped a little bit....Mario

Posted by CCF CARDIO MD - CRC on July 19, 1999 at 09:50:24
Dear Tim,
Mario is correct in the terminology and results, however, this procedure is not performed very often (if at all) due to the advent of mechanical assist devices.  These small pumps called LVADs (left ventricular assist device) do the same thing but in a much better fashion.  With an EF of 25% I doubt your friend will need either of these procedures.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

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