Dynamic aortomyoplasty to assist left ventricular failure.
Dynamic aortomyoplasty to assist left ventricular failure.
复制标题
动态主动脉成形术协助左心室衰竭。
DOI：
10.1016/0003-4975(90)90143-t
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Alain Carpentier
中科院分区：
文献类型：
--
作者：
J. Chachques;P. Grandjean;E. Fischer;C. Latrémouille;Victor A. Jebara;Ivan Bourgeois;Alain Carpentier
骨骼肌收缩力增强左心室功能的有效性已通过实验和临床心肌成形术得到证实。生物力学心脏辅助的另一种方法是在心外位置使用电刺激骨骼肌。我们描述了一种自体反搏动装置，使用原生升主动脉作为心室，由电刺激背阔肌瓣（LDMF）包裹。该模型避免了与假腔相关的骨骼肌新心室中观察到的血栓性并发症。在8只山羊中，通过切除第二根肋骨将右LDMF转移到胸腔。在4只山羊中，通过手术植入（使用侧夹）自体心包补片扩大主动脉直径。将LDMF包裹在升主动脉周围，并使用连接感应心肌导联和LDMF起搏电极的外舒张脉冲发生器进行电刺激。进行血流动力学研究（左心室、主动脉和肺动脉压力以及左心室压力上升率）。LDMF舒张反搏使用30hz的脉冲进行，并调整R波的延迟以提供最佳的舒张增强。在基线和高剂量盐酸心得安（静脉注射3mg /kg）引起的急性心力衰竭后，计算无辅助和辅助心脏周期（1:2）时心内膜下活力指数的增加百分比。受刺激的LDMF的舒张主动脉反搏导致两组在基线和诱导心力衰竭后的心内膜下活力指数显著改善，尽管主动脉扩张组的增加更大。
The efficacy of skeletal muscle contractile force to augment left ventricular function has been demonstrated experimentally and clinically by the cardiomyoplasty procedure. Another approach in biomechanical cardiac assistance is the use of electrostimulated skeletal muscle in an extracardiac position. We describe an autologous counterpulsating device using the native ascending aorta as a ventricular chamber wrapped by an electrostimulated latissimus dorsi muscle flap (LDMF). This model avoids thrombotic complications observed in skeletal muscle neo-ventricles associated with prosthetic chambers. In 8 goats, a right LDMF was transferred to the thoracic cavity by removal of the second rib. In 4 goats, the diameter of the aorta was enlarged by surgical implantation (using lateral clamping) of an autologous pericardial patch. The LDMF was wrapped around the ascending aorta and electrostimulated using an external diastolic pulse generator connected to a sensing myocardial lead and to LDMF pacing electrodes. Hemodynamic studies were performed (left ventricular, aortic, and pulmonary artery pressures and rate of rise of left ventricular pressure). The LDMF diastolic counterpulsation was performed using a burst of 30 Hz, with a delay from the R wave adjusted to provide optimal diastolic augmentation. Percent increase in the subendocardial viability index was calculated during unassisted and assisted cardiac cycles (1:2) at baseline and after acute heart failure induced by the administration of high doses of propranolol hydrochloride (3 mg/kg intravenously). Diastolic aortic counterpulsation by the stimulated LDMF resulted in a significant improvement in the subendocardial viability index both at baseline and after induced cardiac failure in both groups, though the increase was greater in the group with aortic enlargement.
DOI：
--
发表时间：
1987
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Acker,MA;Anderson,WA;Hammond,RL;Chin,AJ;Buchanan,JW;Morse,CC;Kelly,AM;Stephenson,LW
通讯作者：
Stephenson,LW