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Intrathoracic and Extrathoracic Skeletal Muscle Ventricles in Circulation: Left Ventricular Apex‐to‐Aorta Configuration
Author(s) -
Lu Huiplng,
Thomas Gregory A.,
Hammond Robert L.,
Fietsam Robert,
Nakajima Hidehiro,
Isoda Susumu,
Nakajima Hisako,
Colson Michael,
Stephenson Larry W.
Publication year - 1994
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1994.tb00852.x
Subject(s) - medicine , latissimus dorsi muscle , apex (geometry) , aorta , blood flow , hemodynamics , cardiology , nuclear medicine , anatomy
A bstract Skeletal muscle ventricles (SMVs) were constructed from the latissimus dorsi muscle in 12 dogs. In group I (n = 6), SMVs were placed intrathoracic, in the apex of the left hemlthorax. In group II (n = 6), SMVs were positioned extrathoracic between the chest wall and subcutaneous tissue. After a 3‐week vascular delay period, SMVs were electrically precondltloned wlth 2‐Hz continuous stimulation for 6 weeks. At a second procedure, a valved conduit was placed between the left ventrlcular (LV) apex and the SMV, and a second valved condult between the SMV and the thoracic aorta. The SMVs were stimulated to contract during dlestole at a 1:2 ratio wlth the heart. In group I, SMVs generated peak pressures of 91 ± 10 mmHg, pumped 47% of the systemic blood flow (0.73 ± 0.25 vs 1.54 ± 0.42 Umin; p < 0.05), and produced a 25% decrease In the LV systolic tension‐time Index (TTI) (16.9 ± 2.7 vs 12.5 ± 3.3 mmHg sec; p < 0.05). In group II, SMV peak pressure was 93 ± 10 mmHg, SMVs pumped 51% of the systemlc blood flow (0.78 ± 0.10 vs 1.53 ± 0.42 L/min; p < 0.05), and the LV systolic TTI decreased 29% (14.0 ± 0.8 vs 9.9 ± 2.0 mmHg sec; p < 0.05). There was no significant difference between group I and II. These data Indicate that the SMV:LV apex‐to‐aorta configuration is the most effective method reported to date for skeletal muscle cardiac assist. Extrathoracic and Intrathoracic SMVs functioned equally well after connectlon to the circulation. ( J Card Surg 1994;9:332–342 )