| Project/Area Number |
09470286
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Jikei University School of Medicine |
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Principal Investigator |
MORITA Kiyozo Jikei University School of Medicine, Cardiac Surgery, Assistant Professor, 心臓外科, 講師 (70174422)
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| Co-Investigator(Kenkyū-buntansha) |
NOMURA Kouji Jikei University School of Medicine, Cardiac Surgery, Assistant, 医学部, 助手 (40246434)
KOYANAGI Katsushi Jikei University School of Medicine, Cardiac Surgery, Assistant, 医学部, 助手 (60225589)
KUROSAWA Hiromi Jikei University School of Medicine, Cardiac Surgery, Professor, 医学部, 教授 (50075511)
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| Project Period (FY) |
1997 – 1998
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| Project Status |
Completed (Fiscal Year 1998)
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| Budget Amount *help |
¥7,200,000 (Direct Cost: ¥7,200,000)
Fiscal Year 1998: ¥3,200,000 (Direct Cost: ¥3,200,000)
Fiscal Year 1997: ¥4,000,000 (Direct Cost: ¥4,000,000)
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| Keywords | hypoplastic right ventricle / univentricular heart / electrical preconditioning / skeletal muscle graft / 複雑心奇形 / 心室再建術 |
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| Research Abstract |
PURPOSE : The purpose of this experimental study is to establish new surgical procedures of dynamic ventriculoplasty with an electrically stimulated skeletal muscle graft for complex cardiac anomaly.
METHODS : In 12 mongrel dogs, a resected RV free wall was reconstructed with a extended pericardial patch, simulating patch enlargement of the hypoplastic right ventricle (RV). A chronically preconditioned latissimus dorsi graft was placed onto the patch, and was electrically driven with a trained-pulse (20 Hz) . In the other 16 dogs, RV cavity was completely obliterated during a cardiopulmonary bypass (CPB) to simulate univentricular hearts. A modified-Fontan circulation was established with the aortic homograft anastomosed between RA and PA, incorporated with a pericardial pouch as a compression chamber. After a termination of CPB, A latissimus dorsi graft was applied to wrap the pericardial pouch and was stimulated with a trained-pulse (20 Hz).
Results : Graft pacing showed significant augmentation of pulmonary flow and pressure (158*21%, 156*14%, respectively), contributing to restoring normal RV function in the hypoplastic RV model. Similar augmentation of the right heart performance was confirmed in a setting of the modified Fontan procedure for univentricular heart.
Continuous pacing was performed in some animals for 7 hours without evidence of muscle fatigue, thromboembolism and muscle degenaration..
Conclusions : Myo-Ventriculoplasty with electrically stimulated skeletal muscle can restore normal RV performance at a physiological preload, and may provide a surgical option for some types of cardiac anomaly.
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