Experimental development of an electrically stimulated biological skeletal muscle ventricle for chronic aortic counterpulsation

Girsch, Werner; Koller, Rupert; Lanmüller, Hermann; Rab, Matthias; Avanessian, Raymond; Schima, Heinrich; Wolner, Ernst; Seitelberger, Rainald

doi:10.1016/s1010-7940(97)00290-x

Cited by 10 publications

(5 citation statements)

References 11 publications

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“…The inherent elasticity of the pulmonary artery also serves to reduce the effective preload pressure on the muscle of the SMV wall. 13 Earlier SMV configurations 10,12,14 used an inflow and an outflow that required 2 vascular anastomoses. Blood circulated through the device in parallel with the systemic circulation.…”

Section: Smv Designmentioning

confidence: 99%

Counterpulsation From the Skeletal Muscle Ventricle and the Intraaortic Balloon Pump in the Normal and Failing Circulations

et al. 2006

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Background-The intra-aortic balloon pump (IABP) is the device that is in most common use to provide cardiovascular support. A skeletal muscle ventricle (SMV) was configured to produce counterpulsation in the thoracic aorta similar to that obtained with an IABP. The hemodynamic effects of an IABP and a SMV in the same animal and in both normal and failing circulations were assessed. Methods and Results-SMVs were connected to and IABPs were placed in the thoracic aorta of 12 anesthetized pigs.Hemodynamic parameters during the IABP-or the SMV-assisted beat were compared with those during the preassist beat. Acute heart failure was induced in 6 of the pigs by snaring the left anterior descending coronary artery (LAD). The hemodynamic effects of the IABP and the SMV were then reassessed. In the assisted cycles, SMV activation increased the mean aortic diastolic pressure (MADP) by 26.5Ϯ3.5%, the mean diastolic LAD flow by 48.4Ϯ7.2%, and endocardial viability ratio (EVR) by 31.6Ϯ3.8% (PϽ0.0001). In the same animals, IABP assist increased MADP by 19.8Ϯ2.3%, mean diastolic LAD flow by 37.2Ϯ3.9%, and EVR by 21.4Ϯ3.0% (PϽ0.0001). Under acute heart failure conditions, both SMV and IABP assist significantly increased MADP, mean diastolic LAD flow, and EVR. Conclusions-In both the normal and failing circulations, the SMV was an effective counterpulsator, providing cardiac assist that was at least equal to that available from an IABP. The SMV may therefore provide the proven benefits of an IABP in ambulant patients.

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Section: Smv Designmentioning

confidence: 99%

Counterpulsation From the Skeletal Muscle Ventricle and the Intraaortic Balloon Pump in the Normal and Failing Circulations

et al. 2006

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“…Guldner and colleagues have used skeletal muscle to actuate a biomechanical heart formed from a polyurethane material placed in series in the thoracic aorta (7) and reported at the Basic and Applied Myology meeting at Abano Terme, Italy in June 2000 that goats have survived for several months with this configuration. The group from Vienna have used an active homograft formed by wrapping skeletal muscle around a donor aorta placed in parallel with the thoracic aorta (8), and reported their first experiment with recovery from anesthesia at the IFESS meeting in 2000. The Liverpool group (Salmons, Jarvis et al) has formed intrathoracic SMVs in pigs with recovery from anesthesia during 2000 (unpublished).…”

Section: Cardiac Bioassistmentioning

confidence: 99%

Functional Electrical Stimulation for Control of Internal Organ Function

Jarvis

Rijkhoff

2001

Neuromodulation: Technology at the Neural Interface

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“…In a second step, our interdisciplinary working group performed acute experiments in sheep to standardize the surgical procedure for aortic counterpulsation with the SMV. The goal of the third step was to evaluate the hemodynamic benefit if this SMV configuration [10]. The SMV was designed to perform counterpulsation parallel to the descending aorta.…”

Section: Introductionmentioning

confidence: 99%

Preparation of a Skeletal Muscle Ventricle in Sheep: Severe Damage to the Latissimus dorsi Muscle due to Mobilization before Preconditioning

Lanmüller

Girsch²,

Rab³

et al. 2000

Eur Surg Res

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As part of a study examining the use of a skeletal muscle ventricle for cardiac assistance in sheep, a new concept of muscle preconditioning was put into practice. We aimed to produce a latissimus dorsi muscle (LDM) capable of performing chronic work immediately after the construction of a skeletal muscle ventricle. The left LDM was detached from the thoracic wall, divided longitudinally and reattached in situ to achieve vascular delay. The right LDM was left unaffected. Thereafter, preconditioning of both LDM was started according to the clinically approved stimulation protocol for cardiomyoplasty. Preconditioning of the unaffected right LDM in situ resulted in a complete muscle fiber transformation with no signs of degeneration or necrosis. Mobilization of the left LDM before preconditioning led to a distinct damage of the muscle. During conditioning, the increase in burst duration from 2 to 3 impulses in sheep A and from 3 to 5 impulses in sheep B resulted in a homogenous degeneration of the muscle fibers of the left LDM. Histomorphological analysis showed a dramatic increase in the percent perimysial and endomysial connective tissue. The applied concept of muscle prefabrication proved to be a failure. Muscle splitting and mobilization followed by vascular delay and in situ conditioning as a concept of muscle prefabrication should be strictly avoided.

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Experimental development of an electrically stimulated biological skeletal muscle ventricle for chronic aortic counterpulsation

Abstract: The results demonstrate the hemodynamic efficacy of this newly designed biological skeletal muscle ventricle as an aortic counterpulsation device. Chronic experiments using a preconditioned fatigue-resistant muscle will further help to evaluate its possible clinical significance.

Cited by 10 publications

References 11 publications

Counterpulsation From the Skeletal Muscle Ventricle and the Intraaortic Balloon Pump in the Normal and Failing Circulations

Counterpulsation From the Skeletal Muscle Ventricle and the Intraaortic Balloon Pump in the Normal and Failing Circulations

Functional Electrical Stimulation for Control of Internal Organ Function

Preparation of a Skeletal Muscle Ventricle in Sheep: Severe Damage to the Latissimus dorsi Muscle due to Mobilization before Preconditioning

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