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Intrathoracic skeletal muscle ventricles: a feasibility study
T L Hooper1, H Niinami, R L Hammond
1Department of Surgery, Wayne State University, Detroit, Michigan 48201.
Journal of Cardiac Surgery
|September 1, 1991
Summary
Skeletal muscle ventricles (SMVs) implanted in the chest show potential as heart assist devices. These muscle-based pumps demonstrated effective function as both right and left-sided pumps in canine models.
Area of Science:
- Biomedical Engineering
- Cardiovascular Surgery
- Regenerative Medicine
Background:
- Clinical application of skeletal muscle ventricles (SMVs) necessitates thoracic placement.
- Optimizing SMV size and shape is crucial to prevent lung compression and maintain pumping efficacy at physiological preloads.
Purpose of the Study:
- To evaluate the feasibility and functional performance of canine latissimus dorsi-derived SMVs implanted within the thoracic cavity.
- To assess the potential of intrathoracic SMVs as right and left heart assist devices.
Main Methods:
- Custom SMVs were created from the latissimus dorsi muscle in five dogs and placed in the left hemithorax.
- Muscle preconditioning involved 6 weeks of 2-Hz electrical stimulation after a 3-week delay.
- Functional evaluation was performed using a mock circulation device connected to the SMVs.
Main Results:
- Intrathoracic SMV placement allowed easy surgical access to cardiac structures.
- As right-sided pumps, SMVs exceeded native right ventricular stroke volume and stroke work at 10 mmHg preload.
- As left-sided pumps, SMVs achieved approximately half the stroke volume and stroke work of the native left ventricle at 10 mmHg preload.
Conclusions:
- Intrathoracic positioning of SMVs is feasible and facilitates surgical integration.
- SMVs show promise as functional cardiac assist devices, capable of augmenting or replacing right and left ventricular function.