Nakajima H, Nakajima H O, Thomas G A, Hammond R L, Mocek F W, Fietsam R, Pochettino A, Lu H, Spanta A D, Isoda S
Division of Cardiothoracic Surgery, Wayne State University, Detroit, Michigan 48201.
Ann Thorac Surg. 1994 Apr;57(4):912-20. doi: 10.1016/0003-4975(94)90202-x.
Skeletal muscle ventricles (SMVs) were constructed either extrathoracically or intrathoracically in 44 dogs using the left latissimus dorsi muscle. These SMVs functioned as aortic counterpulsators for from several hours to 216 days. In this study, the relationship between the morphologic changes in the SMVs and their time course in the circulation was evaluated retrospectively. The average volume of the SMV chamber after it had been excised and fixed in formalin was 21.3 +/- 11.0 mL (mean +/- the standard deviation) for extrathoracic SMVs and 20.0 +/- 7.5 mL for intrathoracic SMVs. The volume of the SMV chamber did not correlate with the time course in the circulation. The SMV wall was mainly composed of three components: muscular, fibrous, and fatty aspects. The overall thickness of the wall appeared to be preserved over time in the circulation. However, the thickness of the muscular component tended to decrease over time. SMV rupture occurred in 15 dogs between postoperative days 4 and 39. All ruptures occurred at the suture line between the SMV and the vascular conduits. There was some degree of thrombus in 24 SMVs. Before SMVs can be applied clinically for the purpose of cardiac assist, problems with rupture and thrombus formation must be solved. A better understanding of the morphologic changes that take place in the SMV over time also is needed.
在44只犬中，利用左背阔肌在胸外或胸内构建骨骼肌心室（SMV）。这些SMV作为主动脉反搏器工作了数小时至216天。在本研究中，对SMV的形态学变化与其在循环中的时间进程之间的关系进行了回顾性评估。在福尔马林中切除并固定后，胸外SMV腔的平均体积为21.3±11.0 mL（平均值±标准差），胸内SMV腔的平均体积为20.0±7.5 mL。SMV腔的体积与循环中的时间进程无关。SMV壁主要由三个部分组成：肌肉、纤维和脂肪部分。壁的总厚度在循环过程中似乎随时间保持不变。然而，肌肉部分的厚度随时间有减小的趋势。15只犬在术后第4天至39天之间发生了SMV破裂。所有破裂均发生在SMV与血管导管之间的缝合线处。24个SMV中有一定程度的血栓形成。在SMV能够临床应用于心脏辅助之前，必须解决破裂和血栓形成的问题。还需要更好地了解SMV随时间发生的形态学变化。
