Anterior Cardiomyoplasty for late stage ARVD performed in Paris

A typical ARVD patient (45 years old,  male) with properly controled arrhythmias developed in February 2011 major resistant RV failure with NYHA Class III despite a relatively good LVEF (40%).

As indicated in the recent issue of the EHJ (GF Editorial May 2011), I advocated anterior cardiomyoplasty (Cx) instead of heart transplantation (Tx). After several months of discussions (and after reading my book) the patient finally decided Cx which has been performed to day at Georges Pompidou European Hospital in Paris by Dr Chachques and Pr Jean Noel Fabiani (School of Pr Alain Carpentier).
Anterior cardiomyoplasty has been developed for RV cardiomyopathies with major RV dilatation.
In this approach note that the latissimus dorsi is fixed on the diaphragm.Surprising results have been observed with this technique with a long follow-up that I presented in 2000 at the ACC meeting in a session on Advances in Cardiac sugery. I got 10 questions (3 from the two Chairmen Dr Swan and Eleptheriades).
In 2010 Dr Chachques reported his experience in a AHA session...
The mechanism of success is not reinforcement of contraction as originally expected but the decrease of inert blood occupying the poorly contracting right ventricle. In addition, with time, the reduction of stress on myocardial fibers may explain the disappearence of cardiac arrhythmias... as mentioned in my Editorial in EHJ 2011.