[Functional evaluation of skeletal muscle ventricles for circulatory assist]

Skeletal muscle has a potential power for cardiac assist. Two approaches have been used to harvest this power: dynamic cardiomyoplasty, which involves the application of muscle directly to the heart to support cardiac contractile function; and the construction of skeletal muscle pouches or ventricles, which are used as separate pumps working either in parallel or in series with the heart. In this study, we evaluated the function of the skeletal muscle ventricles (SMVs) for circulatory assist. In six dogs (18.5 +/- 2.3 kg, mean +/- S.E.M.), SMVs were constructed from the right latissimus dorsi muscle, and placed in the right hemithorax. After a 3-week vascular delay period, the SMVs were preconditioned electrically by 2 Hz continuous stimulation for six weeks. Nine weeks later, SMVs were connected to a mock circulation device for functional evaluation. As right-sided pumps, at a preload of 10 mmHg, SMVs generated stroke work of 0.63 +/- 0.04 x 10(6) ergs with 25 Hz and 0.80 +/- 0.06 x 10(6) ergs with 85 Hz, which exceeded that of the native right ventricle. As left sided pumps, also at a preload of 10 mmHg, SMV stroke work was 0.49 +/- 0.13 x 10(6) with 25 Hz 0.90 +/- 0.09 x 10(6) ergs, which was roughly half that of the left ventricle. These results demonstrate that SMVs have the potential to function as left or right heart assist devices.