Pericardium-Lined Skeletal Muscle Ventricles: Up to Two Years' In-Circulation Experience1 Gregory A Thomas, Susumu Isoda, Robert L Hammond, Huiping Lu,

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Pericardium-Lined Skeletal Muscle Ventricles: Up to Two Years' In-Circulation Experience1 Gregory A Thomas, Susumu Isoda, Robert L Hammond, Huiping Lu, Hidehiro Nakajima, Hisako O Nakajima, Kevin Greer, Stephen J Gilroy, Stanley Salmons, Larry W Stephenson The Annals of Thoracic Surgery Volume 62, Issue 6, Pages 1698-1706 (December 1996) DOI: 10.1016/S0003-4975(96)00738-2

Fig. 1 Construction of completed skeletal muscle ventricle. The mandrel (not shown) is removed at time of connection to the circulation. The inner pericardial layer forms the blood-contacting surface. The muscle is sewn to a ring of Dacron felt at the base of the skeletal muscle ventricle. The Annals of Thoracic Surgery 1996 62, 1698-1706DOI: (10.1016/S0003-4975(96)00738-2)

Fig. 2 Skeletal muscle ventricle connected to the descending thoracic aorta. Conically shaped base cap with conduits is sewn to a Dacron felt sewing ring. The aorta is ligated between the two conduits. Cardiomyostimulator senses cardiac rhythm, and muscle is stimulated through the thoracodorsal nerve (n). The Annals of Thoracic Surgery 1996 62, 1698-1706DOI: (10.1016/S0003-4975(96)00738-2)

Fig. 3 Hemodynamic traces obtained at time of placing the skeletal muscle ventricle (SMV) into circulation (A), at 12 months (B), and 24 months (C). Stimulation of the SMV at 33 Hz burst frequency and 1:2 contraction ratio is noted by the dots. Stimulator artifact can be seen in the electrocardiographic (ECG) tracing. Effects of SMV contraction on pressure in the SMV, aortic arch, left ventricle (LV), and femoral artery are seen during 1:2 stimulation during initial hemodynamic recording, and also in the arterial traces at 12 and 24 months. (PA = pulmonary artery.) The Annals of Thoracic Surgery 1996 62, 1698-1706DOI: (10.1016/S0003-4975(96)00738-2)

Fig. 4 Augmentation of mean diastolic blood pressure during a control recording and during stimulated beats at 33, 50, and 85 Hz burst frequency stimuli averaged for all animals at sequential points in time. Skeletal muscle ventricle contraction during cardiac diastole increased mean diastolic blood pressure from 15 to 35 mm Hg. Diastolic augmentation was well maintained over the study period. The Annals of Thoracic Surgery 1996 62, 1698-1706DOI: (10.1016/S0003-4975(96)00738-2)

Fig. 5 Peak pressures generated during isovolumic contraction of a skeletal muscle ventricle (SMV) after 779 days in circulation at varying preloads. Peak pressure was 180 mm Hg at a preload of 100 mm Hg. (R = correlation coefficient.) The Annals of Thoracic Surgery 1996 62, 1698-1706DOI: (10.1016/S0003-4975(96)00738-2)

Fig. 6 Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of skeletal muscle ventricle samples from dogs 7 and 8 (a), and Western blot probed with monoclonal antibody antifast myosin WB-MHCf (b). Lane 1: control latissimus dorsi. Lanes 2, 3, and 4: skeletal muscle ventricle samples from the base, middle, and apex, respectively, of dog 7. Lanes 5, 6, and 7: skeletal muscle ventricle samples from the base, middle, and apex of dog 8. Lane 8: control soleus. The control latissimus expresses two fast isoforms, myosin heavy chain 2A and 2D. The skeletal muscle ventricle samples express exclusively the slow isoform of myosin heavy chain 1. Western blot with monoclonal specific for fast myosin heavy chain isoforms shows uptake only in control lanes (b). The Annals of Thoracic Surgery 1996 62, 1698-1706DOI: (10.1016/S0003-4975(96)00738-2)