Cardiocirculatory bio-assist: Is it time to reconsider demand dynamic cardiomyoplasty? Review and future perspectives

Gianluca Rigatelli, Mario Barbiero, Giorgio Rigatelli, Angelo Cotogni, Roberto Riccardi, Franco Cobelli, Ugo Carraro

Research output: Contribution to journalArticlepeer-review


In the last 15 years, dynamic cardiomyoplasty has remained an experimental procedure even after the enthusiastic short- and mid-term results, mainly because of the disappointing long-term outcome caused by muscular degeneration secondary to chronic continuous electrical stimulation of the latissimus dorsi. In Italy, a group of muscular pathologists, cardiologists, and cardiac surgeons conducted an experiment of an activity-rest stimulation protocol in humans that should avoid complete transformation of the skeletal muscle, maintaining its properties overtime. This "demand" stimulation protocol gave good results, improving New York Heart Association class, ejection fraction value, and survival. Even though dynamic cardiomyoplasty was excluded from the recent international guidelines for the management of heart failure, the discussion on the ability of this unique kind of cardiocirculatory bio-assistance is due to be reopened, thanks to the results of the new stimulation protocol. Heart transplantation, circulatory supporting devices, multisite stimulation therapy, and the total artificial heart are not always and in all countries the best solutions: the great economic cost, the numerous contraindications, the need for immunosuppression and antithrombotic therapy, and the troublesome follow up constitute important drawbacks. For patients in whom transplant surgery cannot be performed, as well as in developing countries, the nonprohibitively expensive demand dynamic cardiomyoplasty may still play a role.

Original languageEnglish
Pages (from-to)24-29
Number of pages6
JournalASAIO Journal
Issue number1
Publication statusPublished - Jan 2003

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering


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