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Ann Thorac Surg 1992;53:750-757
© 1992 The Society of Thoracic Surgeons

Articles

Skeletal muscle ventricles in the pulmonary circulation: Up to 16 weeks' experience

Robert L. Hammond, BA, Renato Ruggiero, MD, Huiping Lu, MD, Ali D. Spanta, MD, Alberto Pochettino, MD, Michael Colson, MS, Hiroshi Niinami, MD1, Larry W. Stephenson, MD*

Timothy L. Hooper, MDa,2

a Division of Cardiothoracic Surgery, Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan USA

* Address reprint requests to Dr Stephenson, Division of Cardiothoracic Surgery, Wayne State University, Harper Professional Building, Suite 228, 4160 John R St, Detroit, MI 48201.

Skeletal muscle ventricles (SMVs) were constructed from the right latissimus dorsi muscle of 8 mongrel dogs. After a 3-week vascular delay period, each SMV was electrically preconditioned with 2-Hz continuous stimulation of the thoracodorsal nerve for 6 weeks. A porcine-valved conduit was then anastomosed between the right ventricle and the SMV, with a second valved conduit connecting the SMV to the main pulmonary artery. The pulmonary artery was then ligated proximal to the conduit. The SMVs were stimulated to contract in 1:2 diastolic mode with a 33-Hz burst frequency. Effective right ventricular assist was achieved in all dogs. Cardiac output increased by 22.6% (1,799 ± 97 versus 1,467 ± 84 mL/min; p < 0.001), systemic systolic arterial pressure by 9.3% (90.1 ± 3.5 versus 82.4 ± 3.9 mm Hg; p < 0.005), and peak pulmonary artery pressure by 318% (27.8 ± 2.0 versus 21.1 ± 1.7 mm Hg; p < 0.001) at the initiation of this study. In 6 dogs, effective right heart assist was sustained for periods of between 1 week and 12 weeks. Two dogs survived for longer than 3 months, though with evidence of deteriorating SMV function. These results demonstrate the feasibility of providing sustained right ventricular assist using this modified "Rastelli-SMV" configuration, which obviates the limitations imposed by low right atrial preload.




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