ТЕКСТ 4

HEART DISEASE: AN ALTERNATIVE TO TRANSPLANT

WASHINGTON - For the many people who wait futilely each year for heart transplants, researchers are looking at a new option: an ex­perimental operation that wraps the failing heart with a back muscle that contracts to help boost the heart's ability to pump blood.

Known as cardiomyoplasty, the procedure is undergoing evaluation at five medical centers.

"It is a very interesting new technique that may have some use," said Sidney Levitsky, chief of cardiothoracic surgery at the New England Deaconess Hospital in Boston and a member of the American Heart As­sociation's Council of Cardiovascular Surgery. In certain patients with heart failure, "it may be the solution for the transplant problem," he said.

Now, doctors report that death rates range from 0 to 20 percent within one month of surgery at the different hospitals involved.

Many of the deaths are attributed to a range of problems that reflect other underlying heart conditions not corrected by the surgery, including irregular heartbeats and ventricular problems. Some patients have also died from other illnesses, including pneumonia.

George McGovern, the surgeon who first performed the operation at Allegheny General, said about 50 percent of the patients there have sur­vived for five years after surgery.

In comparison, approximately 80 to 85 percent of hearttransplant patients survive one year after surgery.

The concept of cardiomyoplasty has been discussed by physicians for more than 50 years. But there were two major hurdles to overcome.

The first was how to condition a skeletal muscle not to tire during 24 hours of daily contraction. Wayne State University thoracic surgeon Larry Stephenson developed the technique using electrical current to over­come this obstacle.

The second was how to get a large enough contraction to boost the heart's production. Standard pacemakers produced small contractions, not enough to help the failing heart. But a researcher, Ray C.-J. Chiu, at McGill University in Montreal developed what is called a burst pace­maker to stimulate the back muscle.

One of the patients to benefit from the surgery was 74-year-old Reaugh Bonn, a retired business executive who developed congestive heart failure suddenly in 1988.

Despite extensive treatment, Mr. Bonn continued to deteriorate. His age disqualified him for a heart transplant.

"It was terribly discouraging," he said from his home in Vancouver, Washington. "The only story that I really got out of any doctor was that there was no cure and that I would progressively go downhill until it was all over.

Then Mr. Bonn read an item about cardiomyoplasty in a tabloid newspaper and sought out the operation.

On July II, 1991, Mr. Bonn became the first patient to undergo car­diomyoplasty at St. Vincent Hospital and Medical Center in Portland, Oregon. He spent 11 days recovering in the hospital, two and a half of them in the intensive-care unit, before being discharged. "The day I got out of the hospital I went home, took a nap and then went out to dinner with my wife," he said.

Sally Squires, International Herald Tribune

Дата добавления: 2015-10-16