Cardiomyopexy is a historical cardiac surgical procedure in which a skeletal muscle (typically the pectoralis major) was surgically detached from its normal attachment and sutured directly onto the cardiac muscle, with the aim of improving blood supply to the heart by encouraging new blood vessels to grow from the skeletal muscle into the myocardium.
The procedure was developed in the era before coronary artery bypass grafting became available, as a means of treating angina and heart failure caused by coronary artery disease. By stitching a well-vascularised skeletal muscle against the heart, surgeons hoped to promote collateral vascular supply to oxygen-deprived myocardium. Clinical results were inconsistent.
Cardiomyopexy is no longer performed. It has been entirely superseded by coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and other revascularisation techniques that more reliably restore coronary blood flow.
The term is occasionally encountered in connection with dynamic cardiomyoplasty, a later refinement in which the latissimus dorsi muscle was wrapped around the heart and electrically stimulated to contract in synchrony with the heartbeat, acting as an auxiliary pump. This procedure is also largely of historical interest now that implantable ventricular assist devices and heart transplantation are well-established treatments for end-stage heart failure.
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