Pericardium-lined skeletal muscle ventricles: up to two years' in-circulation experience.
Pericardium-lined skeletal muscle ventricles: up to two years' in-circulation experience.
复制标题
心包衬里的骨骼肌心室：长达两年的循环经验。
DOI：
10.1016/s0003-4975(96)00738-2
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Stephenson,LW
中科院分区：
文献类型：
--
作者：
Thomas,GA;Isoda,S;Hammond,RL;Lu,H;Nakajima,H;Nakajima,HO;Greer,K;Gilroy,SJ;Salmons,S;Stephenson,LW
骨骼肌心室（smv）是由骨骼肌构成的自体泵腔。骨骼肌心室破裂和血栓栓塞是这种骨骼肌心脏辅助方法的复杂慢性模型。方法以10只犬背阔肌为材料构建smv。每个SMV的内表面内衬在SMV构建时收获的自体心包。经过3周的血管延迟和6周的电调节，将肌肉转化为抗疲劳状态，smv连接到胸降主动脉，并在心脏舒张期间刺激其收缩。结果初始血流动力学显示，33 Hz时SMV收缩使舒张压升高24.7%（60.8±7.3 mm Hg vs 80.3±8.8 mm Hg）。骨骼肌心室舒张使收缩压降低14.4%(59.9±7.7 mm Hg vs 51.3±7.5 mm Hg)，收缩压峰值降低4.1%（90.2±7.3 mm Hg vs 86.5±5.8 mm Hg）。在1 ~ 2周，然后在1、2、3和6个月，之后每隔6个月评估一次血流动力学。血流动力学性能在研究期间保持稳定。连续泵血2年后，SMV收缩导致舒张压升高34.8%(63.6±6.6 mm Hg vs 85.3±6.4 mm Hg)，收缩压降低17.2%(54.7±3.73 mm Hg vs 45.3±4.1 mm Hg)，收缩压峰值降低4.2%（95.3±10.4 mm Hg vs 91.3±12.3 mm Hg）。有3只狗在smv的循环中存活了2年。在连续超声心动图或尸检中，没有动物显示血栓栓塞的证据，也没有smv破裂。结论：这些数据表明，smv可以在较长时间内提供有效的血流动力学辅助，而不会出现与smv相关的特定并发症。
BackgroundSkeletal muscle ventricles (SMVs) are autologous pumping chambers constructed from skeletal muscle. Skeletal muscle ventricular rupture and thromboembolism have complicated chronic models of this method of skeletal muscle cardiac assist.MethodsThe SMVs were constructed from the latissimus dorsi muscle in 10 dogs. The inner surface of each SMV was lined with autologous pericardium harvested at the time of SMV construction. After a 3-week period of vascular delay and 6 weeks of electrical conditioning to convert the muscle to a fatigue-resistant state, SMVs were connected to the descending thoracic aorta and stimulated to contract during cardiac diastole.ResultsInitial hemodynamics revealed that SMV contraction at 33 Hz increased diastolic pressure 24.7% (60.8 ± 7.3 mm Hg versus 80.3 ± 8.8 mm Hg). Skeletal muscle ventricle relaxation decreased presystolic pressure 14.4% (59.9 ± 7.7 mm Hg versus 51.3 ± 7.5 mm Hg) and decreased peak systolic pressure 4.1% (90.2 ± 7.3 mm Hg versus 86.5 ± 5.8 mm Hg). Hemodynamics were assessed at 1 to 2 weeks, then at 1, 2, 3, and 6 months, and at 6-month intervals thereafter. Hemodynamic performance remained stable for the duration of this study. After 2 years of pumping continuously in circulation, SMV contraction resulted in a 34.8% augmentation of diastolic pressure (63.6 ± 6.6 mm Hg versus 85.3 ± 6.4 mm Hg), a 17.2% decrease in presystolic pressure (54.7 ± 3.73 mm Hg versus 45.3 ± 4.1 mm Hg), and a 4.2% decrease in peak systolic pressure (95.3 ± 10.4 mm Hg versus 91.3 ± 12.3 mm Hg). Three dogs survived to 2 years with the SMVs in circulation. No animal showed evidence of thromboembolism during serial echocardiography or at autopsy and no SMVs ruptured.ConclusionsThese data demonstrate that SMVs can provide effective hemodynamic assist over an extended period without specific complications related to the SMVs.