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Ann Thorac Surg 1996;62:1706-1707
© 1996 The Society of Thoracic Surgeons

Discussion

Discussion

The first 300 words of the full text of this article appear below.

See also page 1698.

DR JAMES A. MAGOVERN (Pittsburgh, PA): Doctor Thomas and his colleagues from Dr Stephenson's laboratory at Wayne State should be commended for this important work. Chronic experimental studies are difficult, very time consuming, and expensive, but are essential for the development of new procedures in cardiac surgery.

A scientific study should be judged on how well it answers the questions that have been posed. This study has asked the question whether a skeletal muscle ventricle connected to the descending aorta can provide long-term counterpulsation. The answer to this question is a clear yes. Doctor Thomas and co-workers have shown both augmentation of diastolic blood pressure and reduction in presystolic blood pressure in serial studies in dogs for periods of months and years.

The larger question, which they have not addressed, is how chronic counterpulsation will affect the heart, especially in the context of congestive heart failure. It is logical to assume that counterpulsation with a skeletal muscle ventricle will be very similar to that with an intraaortic balloon pump, but these data will need to be generated before starting clinical applications.

Another question is whether this type of work will eventually lead to clinical application. There have been three major problems with skeletal muscle ventricle research:

The first is the structural integrity of the ventricles. There are high stresses applied to the ventricle, and over time rupture of the ventricle can occur. This problem appears to be solved with technical modifications in the operative technique.

The second problem is thromboembolism. As you can imagine, when blood is pumped there is a large potential for thromboembolism. This problem also appears to be largely resolved with technical modifications of the skeletal muscle ventricle, especially with the pericardial lining. However, this is still an area of concern. There are . . . [Full Text of this Article]


Related Article

Pericardium-Lined Skeletal Muscle Ventricles: Up to Two Years' In-Circulation Experience
Gregory A. Thomas, Susumu Isoda, Robert L. Hammond, Huiping Lu, Hidehiro Nakajima, Hisako O. Nakajima, Kevin Greer, Stephen J. Gilroy, Stanley Salmons, and Larry W. Stephenson
Ann. Thorac. Surg. 1996 62: 1698-1706. [Abstract] [Full Text]





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