[Skeletal muscle ventricle used for right ventricle assistance]

There are a number of advantages in using an electrically stimulated autogenous skeletal muscle to construct an auxiliary ventricle to assist a heart. The purpose of this study was to determine the feasibility of biological right ventricular assistance using long-term electrically stimulated skeletal muscle grafts. In fourteen dogs, the latissimus dorsi muscles and the right thoracodorsal nerves were exposed and unipolar pulse generator was implanted. The initial rate of 70 cycle/min. was increased to a rate of 100 cycle/min. Six or 12 months later, the latissimus dorsi was wrapped around a latex pouch equipped with inflow and outflow valved conduit (skeletal muscle ventricles; SMVs). The SMVs were connected to main pulmonary artery and right atrium. These SMVs were stimulated 20 Hz for 200 msec at a fixed rate of 90 cycle/min, the hemodynamic changes with or without skeletal muscle ventricular assistance (SMVA) were measured. In as animals the circulation failed after total right ventricular bypass without SMVA. But the SMVA increased aortic blood pressure, aortic blood flow, left atrial pressure and peak pulmonary pressure significantly. There was a linear correlation between central venous pressure and skeletal muscle ventricular assist flow. Histologic studies showed the conditioned muscles had a greater percentage of slow-twitch, fatigue resistant fibers on ATPase stain. These results suggested the long-term electrical conditioning skeletal muscle could be possible to use SMVs in humans to provide support in children with some types of congenital heart disease.