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Thorac Cardiovasc Surg 2002; 50(2): 82-86
DOI: 10.1055/s-2002-26699
Original Cardiovascular
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Operative Procedure and Volumetry in
Experimental Biomechanical Hearts

N.  W.  Guldner1 , P.  Klapproth1 , M.  Großherr2 , M.  Stephan1 , R.  Noel3 , H.-H.  Sievers1
  • 1Clinic of Cardiac Surgery, Lübeck Medical University, Germany
  • 2Clinic of Anaesthesiology, Lübeck Medical University, Germany
  • 3Dept. of Animal Care, Lübeck Medical University, Germany
This paper was presented an the 30th Meeting of the German Society for Thoracic andCardiovascular Surgery in Leipzig, February 18 - 21, 2001.
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Publication History

Publication Date:
30 April 2002 (online)

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Abstract

Background: To date, skeletal muscle ventricles (SMVs) have been integrated into the circulation by a second operation following construction, vascular delay and several weeks of electrical conditioning. Recently, intra-thoracic SMVs around a mock system contracted against a pressure of 70 mmHg for several months immediately after construction in the presence of clenbuterol. This indicates that the two-step procedure may be exchanged for a clinically favorable one-step operation. The stroke volume is tested intra-operatively. Methods: In twelve Boer goats, the latissimus dorsi muscle was folded in a double layer around a polyurethane chamber, which was integrated into descending thoracic aorta. This muscular flow-through chamber containing a stabilizing inner layer denoted “Biomechanical Heart” (BMH) showed immediate activity against systemic pressure. The conductance catheter method was applied for analysis of intra-operative stroke volume. Results: The one-step operative procedure employed was practicable in all 12 goats. Operative complications were eliminated without difficulty. Intraoperative application of the conductance catheter resulted in BMH with a stroke volume of 55 ± 14 ml. In the best BMH on postoperative day 132, a continuous pumping capacity of 1.4 l/min was measured. This BMH functioned up to day 414 postoperatively, and failed due to a rupture of the pumping chamber. Conclusion: This operative procedure and dynamic volumetry of experimental Biomechanical Hearts might be relevant for clinical use.

Key words

Muscle - Electrostimulation - Cardiac assistance - Clenbuterol

References

  • 1 Salmons S, Jarvis J C. Cardiac assistance from skeletal muscle: a critical appraisal of the various approaches.  Br Heart J. 1992;  68 333-338
    PubMedSearch in Google Scholar
  • 2 Acker M A, Hammond R L, Mannion J D, Salmons S, Stephenson L W. Skeletal muscle as the potential power source for a cardiovascular pump: assessment in vivo.  Science. 1987;  236 324-327
    PubMedSearch in Google Scholar
  • 3 Bridges C R, Brown W E, Hammond R L. et al . Skeletal muscle ventricles: Improved performance at physiologic preloads.  Surgery. 1989;  106 275-282
    PubMedSearch in Google Scholar
  • 4 Hooper T L, Niinami H, Hammond R L, Lu H, Ruggiero R, Pochettino A, Stephenson L W. Skeletal muscle ventricles as left atrial-aortic pumps: short-term studies.  Ann Thorac Surg. 1992;  54 316-322
    PubMedSearch in Google Scholar
  • 5 Lu H, Fietsam R Jr, Hammond R L, Nakajima H. et al . Skeletal muscle ventricles: left ventricular apex to aorta configuration.  Ann Thorac Surg. 1993;  55 78-85
    PubMedSearch in Google Scholar
  • 6 Guldner N W, Eichstaedt H C, Klapproth P. et al . Dynamic training of skeletal muscle ventricles. A method to increase muscular power for cardiac assistance.  Circulation. 1994;  89 (3) 1032-1040
    PubMedSearch in Google Scholar
  • 7 Guldner N W, Klapproth P, Fischer T. et al . Functionally adapted stimulation patterns for a dynamic training of skeletal muscle ventricles in adult goats.  BAM. 1997;  8 (1) 67-72
    PubMedSearch in Google Scholar
  • 8 Guldner N W, Klapproth P, Großherr M, Rumpel E, Noel R, Sievers H H. Clenbuterol supported Dynamic Training of Skeletal Muscle Ventricles Against Systemic Load - A Key for Powerful Circulatory Assist?.  Circulation. 2000;  101 2213-2219
    PubMedSearch in Google Scholar
  • 9 Baan J. Continous measurement of ventricular volume by conductance catheter. Winter Uj Impedance measurement in the clinical cardiology. Darmstadt: Steinkopff
  • 10 Baan J, van der Velde E T, Steendijk P, Koops J. Calibration and application of the conductance catheter for ventricular volume measurement.  Automedica. 1989;  11 357-365
    PubMedSearch in Google Scholar
  • 11 Baan J, Aouw J ong, Kerkhof P LM. et al . Continous stroke volume and cardiac output from intra-ventricular dimension obtained with impedance catheter.  Cardiovasc Res. 1981;  15 328-334
    PubMedSearch in Google Scholar
  • 12 Klapproth P. Methodik zur Evaluierung eines dynamischen Trainings für Skelettmuskelventrikel am Trainingsgerät und am Biomechanischen Herzen. Inauguraldissertation Med. Univ. Lübeck 1999
    Search in Google Scholar
  • 13 Guldner N W, Siemens H-J, Schramm U. et al . First Clinical Application of the Medos HIA Ventricular Support System: Monitoring of the Thrombotic Risk by Means of the Biomarker Prothrombin Fragment F1 + F2 and Scanning Electron Microscopy Evaluation .  J Heart and Lung Transpl. 1996;  15 (3) 291-296
    PubMedSearch in Google Scholar
  • 14 Thomas G A, Hammond R L, Greer K. et al . Functional assessment of skeletal muscle ventricles after pumping for up to four years in circulation.  Ann Thorac Surg. 2000;  70 (4) 1281-1289
    CrossrefPubMedSearch in Google Scholar

Priv. Doz. Dr. med. Norbert W. Guldner

Klinik für Herzchirurgie, Medizinische Universität zu Lübeck


Ratzeburger Allee 160

23538 Lübeck

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Phone: +49 (451) 500-4125

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Email: guldner@medinf.mu-luebeck.de