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Functional right-heart replacement with skeletal muscle ventricles.
C R Bridges1, R L Hammond, F Dimeo
1Harrison Department of Surgical Research, Department of Surgery, University of Pennsylvania, Philadelphia.
Circulation
|November 1, 1989
Summary
Skeletal muscle ventricles can effectively replace right heart function in dogs, demonstrating near-physiological performance during extended bypass. This research highlights the potential of muscle-derived ventricles for cardiac support.
Area of Science:
- Biomedical Engineering
- Cardiovascular Surgery
- Regenerative Medicine
Background:
- The limitations of current artificial cardiac assist devices necessitate innovative solutions.
- Skeletal muscle has been explored as a viable autologous tissue for cardiac reconstruction.
Purpose of the Study:
- To evaluate the functional capacity of skeletal muscle ventricles in supporting right heart function.
- To assess the performance of latissimus dorsi-derived muscle ventricles during prolonged right-heart bypass in a canine model.
Main Methods:
- Skeletal muscle ventricles were constructed from the latissimus dorsi in seven dogs.
- Vascular delay and electrical preconditioning were applied to the muscle ventricles.
- Group 1 underwent complete right-heart bypass using the muscle ventricle; Group 2 used it for partial bypass.
- Hemodynamic parameters were monitored during up to 8 hours of bypass.
Main Results:
- In complete bypass, skeletal muscle ventricles achieved 163% of native right ventricular stroke work after 4 hours.
- Skeletal muscle ventricle output averaged 1.14 L/min with a central venous pressure of 13 mm Hg.
- Systemic systolic blood pressure was maintained at 95 mm Hg, indicating adequate circulatory support.
Conclusions:
- Skeletal muscle ventricles can perform the workload of the right heart.
- This approach supports cardiac function with near-physiological filling pressures.
- Muscle-derived ventricles show promise for right heart replacement or support.