Indications and risk analysis for clinical cardiomyoplasty.

T he use of conditioned skeletal muscle for cardiac assistance is an attractive potential therapy for congestive heart failure. In experimental studies skeletal muscle power has been used to generate diastolic aortic counterpulsation’ and to drive skeletal muscle ventricles.* Clinical work has focused on cardiomyoplasty, a procedure in which the left latissimus dorsi (LD) with its intact neurovascular bundle is mobilized from the chest wall, transposed into the chest, and applied to the ventricles. We have now performed 13 cardiomyoplasty operations. In this article we analyze our initial clinical experience with the procedure to define indications and results of cardiomyoplasty and to identify areas for continued investigation.