Skeletal Muscle Used as Experimental Cardiac Assist: Russian Experience

Abstract

This manuscript presents experimental data in the area of biomechanical cardiac support obtained at the Bakulev Institute for Cardiovascular Surgery in Moscow, Russia. After creation of the left ventricular aneurysm and subsequent cardiomyoplasty, active functioning of the muscle–heart complex was observed. In the late postoperative stages (3–6 months) hemodynamic parameters did not reach original preoperative values, but were satisfactory to support decreasing heart function: Cardiac index was decreased by 9.8%, the pumping coefficient of the left heart (KLH) by 24.7%, and left ventricular stroke work index (LVSWI) fell by 25%. Acute aneurysm of the left ventricle is a good model to study the effectiveness of cardiomyoplasty. Determination of parameters for stimulation of the muscle autograft showed that from the point of view of hemodynamic parameters of the muscle-heart complex, the optimal initial training schedule is a burst of seven pulses, each from 0.07 to 0.6 ms in duration, with a frequency of 30–50 Hz, an amplitude of 6 V, and a burst following frequency of 15–30 per minute.

Key Words:

• cardiomyoplasty
• skeletal muscle
• cardiac assist
• electrical stimulation