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Ann Thorac Surg 1992;54:316-322
© 1992 The Society of Thoracic Surgeons

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Articles

Skeletal muscle ventricles as left atrial-aortic pumps: Short-term studies

Division of Cardiothoracic Surgery, Wayne State University, Detroit, Michigan USA

Accepted for publication January 14, 1992.

^_* Address reprint requests to Dr Stephenson, Division of Cardiothoracic Surgery, Wayne State University, Harper Professional Building, Suite 228, Detroit, MI 48225.

In 5 dogs, skeletal muscle ventricles (SMVs) were constructed from the latissimus dorsi muscle and placed in the left hemithorax. After a 3-week vascular delay period, SMVs were electrically preconditioned with 2-Hz stimulation for 6 weeks. At a second operation, SMVs were connected between the left atrium and thoracic aorta by afferent and efferent aortic root homografts, and stimulated to contract in a 1:2 diastolic mode. At a mean left atrial pressure of 12.4 ± 1.3 mm Hg and a burst stimulation frequency of 33 Hz, SMV stroke volume was initially 43% of that of the native left ventricle, achieving a flow equivalent to 21% of cardiac output (194 ± 38 versus 902 ± 85 mL/min). At 50-Hz stimulation, this figure rose to 27% (246 ± 41 mL/min; p < 0.05). Skeletal muscle ventricle power output (the product of stroke work and contraction rate) at 33 Hz was 0.016 ± 0.003 W, increasing to 0.024 ± 0.004 W at 50 Hz (p < 0.05), corresponding to 14% and 22%, respectively, of left ventricular power output (0.11 ± 0.012 W). After 4 hours of continuous pumping, four of the SMVs were still generating flows of more than 70% of starting values and more than 60% of initial power output. This study demonstrates that SMVs can function in the systemic circulation at physiologic left atrial preloads.

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