Skeletal muscle as a myocardial substitute.

During the last several years, there has been intense worldwide interest concerning the use of skeletal muscle as a form of cardiac assistance. For over 10,000 people in the United States diagnosed each year with irreversible heart failure, the 1-year mortality approaches 50%. This comes despite recent advances in medical therapy, heart transplantation, and the artificial heart program. Because of the limitations of these treatments in terms of effectiveness, cost, and availability, we have used a different approach for cardiac augmentation. Skeletal muscle is shaped into the form of a pumping chamber and then used to aid the function of the failing myocardium. Another approach is cardiomyoplasty, where the latissimus dorsi muscle is wrapped around the heart and stimulated to contract in synchrony with the patient's failing myocardium. More than 500 patients have undergone cardiomyoplasty worldwide. These two areas of investigation represent the principle methods for skeletal muscle cardiac assistance.