Second, the operative mortality has been significant and, in the opinion of many clinical investigators, unjustifiably so for NYHA Class II and III patients who can be managed pharmacologically with considerable success in the current era. Recently, Moreira and Stolf published a timely review of this subject, pointing out two significant new developments in this old story better understanding of the potential mechanisms of benefit from myoplasty and improved surgical results. With improvement in anesthetic management and increasing surgical experience, mortality for the operation has been reduced significantly. These results tend to override previous widespread concerns that the mortality of the procedure was comparable to that seen with medical therapy for advanced heart failure and suggest that this procedure will now take its place alongside other invasive modalities for treatment of the failing heart. Given the continuing shortage of suitable heart donors, which restricts biologic heart replacement to fewer than 3,000 recipients per year, this procedure will likely become much more commonly utilized.
Clinical investigation continues to refine selection criteria.
Mount Kisco, NY, Futura Publishing Co., 1991. Magovern JA, Park SE, Cmolik BL, et al. Early effects of right latissimus dorsi cardiomyoplasty on left ventricular function.