Composite cardiac binding in experimental heart failure

Background. Composite cardiac binding consists of wrapping the heart with a synthetic membrane and a pericardial interposition. The goal of the present study was to apply composite cardiac binding to a canine model of heart failure. Methods. Twenty dogs were randomized to 2 groups: untreated heart failure (group 1, n = 13) and heart failure pretreated by composite cardiac binding (group 2, n = 7). They received a total dose of 1 mg x kg(-1) of intracoronary doxorubicin over 4 weeks. Hemodynamic data were obtained at weeks 0, 7, and 12. All animals were followed up with weekly echocardiography for 12 weeks. Results. Survival in group 1 was 54% and in group 2 was 100% at week 12 (p = 0.0438). Left ventricular end-diastolic pressure increased by 153% in group 1 and by 59% in group 2 (p = 0.0395) at week 12. Ejection fraction decreased by 27% in group 1 and by 19% in group 2 (p = 0.4401) at week 12. Conclusions. Composite cardiac binding significantly prolongs survival and attenuates left ventricular dilatation and the increase in left ventricular end-diastolic pressure associated to chronic heart failure. Further evaluation in established heart failure is needed. Composite cardiac binding may be used for the prevention of recurrent dilatation following reduction ventriculoplasty. (C) 2000 by The Society of Thoracic Surgeons.