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Ann Thorac Surg 1993;55:78-85
© 1993 The Society of Thoracic Surgeons

Articles

Skeletal muscle ventricles: Left ventricular apex to aorta configuration

Huiping Lu, MDa,b, Robert Fietsam, Jr, MDa,b, Robert L. Hammond, BAa,b, Hidehiro Nakajima, MDa,b, Frank W. Mocek, MDa,b, Gregory A. Thomas, MDa,b, Renato Ruggiero, MDa,b, Hisako Nakajima, MDa,b, Michael Colson, MSa,b, Larry W. Stephenson, MD*,a,b

a Division of Cardiothoracic Surgery, Department of Surgery, Wayne State University, Detroit, Michigan, USA
b Medtronic, Inc, Minneapolis, Minnesota USA

Accepted for publication April 23, 1992.

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

Skeletal muscle ventricles (SMVs) were constructed from the latissimus dorsi muscle in 6 dogs. After 3 weeks of vascular delay followed by 6 weeks of 2-Hz continuous electrical conditioning, a valved conduit was placed between the left ventricular apex and the SMV and a second valved conduit, between the SMV and the aorta. The SMV was stimulated to contract during diastole at a 1:2 ratio with the heart. The SMV pumped 47% of the systemic blood flow initially (0.73 ± 0.23 versus 1.54 ± 0.42 L/min) and 40% after 3 hours. Skeletal muscle ventricle stimulation resulted in a 58% increase in mean diastolic pressure initially (52 ± 9 to 82 ± 11 mm Hg; p < 0.05) and a 73% increase (45 ± 7 to 78 ± 8 mm Hg) after 3 hours of continuous pumping. This was associated with a 68% increase in the endocardial viability ratio initially and a 63% increase at 3 hours. The systolic tension-time index decreased by 26% initially and 25% at 3 hours. This study indicates that the SMV configuration of left ventricular apex to aorta may be particularly suitable for left ventricular assist.




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