Skeletal muscle as a myocardial substitute

Area of Science:

• Biomedical Engineering
• Cardiovascular Surgery
• Skeletal Muscle Physiology

Background:

• Skeletal muscle has been explored for cardiac surgery applications, evolving from passive reinforcement to active blood pumping.
• Early attempts faced limitations due to skeletal muscle fatigue, hindering sustained cardiac assistance.
• Electrical conditioning has demonstrated the potential to render skeletal muscle fatigue-resistant for cardiac-type work.

Purpose of the Study:

• To review the historical use and evolving applications of skeletal muscle in cardiac surgery.
• To evaluate the efficacy and limitations of cardiomyoplasty and aortomyoplasty techniques.
• To explore the potential of skeletal muscle ventricles as an alternative cardiac assist device.

Main Methods:

• Review of historical experiments and clinical applications of skeletal muscle in cardiac surgery.
• Analysis of cardiomyoplasty and aortomyoplasty techniques, including human application data.
• Evaluation of animal studies on skeletal muscle ventricles as artificial pumping chambers.

Main Results:

• Cardiomyoplasty and aortomyoplasty have shown controversial effectiveness in humans, with inconsistent hemodynamic improvements despite clinical benefits.
• Skeletal muscle ventricles, though not yet applied in humans, demonstrate convincing results in animal models.
• Skeletal muscle ventricles achieved significant and stable improvements in hemodynamic parameters in animal studies.

Conclusions:

• While direct muscle wrapping techniques have limitations, skeletal muscle ventricles represent a promising advancement in cardiac assistance.
• Further research and human trials are warranted to validate the efficacy of skeletal muscle ventricles.
• Skeletal muscle's potential for fatigue-resistant cardiac support is significant, particularly in ventricle configurations.