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The Value of the Echo‐Doppler in Cardiomyoplasty Procedures

Echo‐Doppler determinations were performed in patients submitted to cardlomyoplasty procedure using the latissimus dorsi muscle graft (LDMG). In four patients who had 1 year of follow‐up or more the left ventricular internal dimension in diastole (LVIDd), left ventricular internal dimension in systole (LVIDs), septal‐E point separation (E‐septum), distance of the mitral valve (E‐E'), maximal aortic cuspid separation (MACS) and left atrium dimension (LA) were determined by two‐dimensional echocardiogram. With a pulsed Doppler in the aortic root the following parameters were obtained: aortic peak flow (AoPF), velocity time integral (VTI), and ejection period (EP). With the stimulator on, the determinations were done using a ventricle muscle (VM) delay of 25, 75, and 250 msec. Results: No significant differences were observed by Echo determinations between the stimulator off and on. With the supporting contraction of the LDMG the best hemodynamic performance was obtained when the VM delay ranged between 75 and 250 msec. Values with the stimulator off and on were as follows: AoPF: 90.8 ± 8 cm/sec and 104.5 ± 9 cm/sec; VTI: 14.8 ± 2 cm and 19.2 ± 2 cm; EP: 230 ± 10 msec and 245 ± 20 msec. A decrease in the systolic pressure of the pulmonary artery and a decreased functional regurgitation of the mitral and tricuspid valve were observed in the follow‐up determinations. All patients showed restricted mitral flows that remained unchanged during the follow‐up. Conclusions: In this group of patients the echo‐Doppler showed an improvement of the systolic function of the left ventricle when it is supported by the LDMG. This study adequately determines the optimal VM delay. It may constitute a reliable method for the follow‐up evaluation.