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  • Title: Dynamic patch artificial myocardium; effects on the residual myocardial function.
    Author: Kyo S, Emoto H, Yamanaka H, Takamoto S, Yokote Y, Omoto R, Buckley MJ, Austen WG.
    Journal: Jpn Circ J; 1984 Mar; 48(3):266-75. PubMed ID: 6231389.
    Abstract:
    Dynamic patch artificial myocardium (D-PATCH) has been developed to replace the damaged left ventricular (LV) wall in severe cardiogenic shock patients with a massive myocardial infarction. This study was undertaken to demonstrate the effects of (1) single D-PATCH support on the global cardiac function (group 1, 12 dogs, whole heart model), (2) single D-PATCH support on the LV function and myocardial metabolism (group 2, 6 dogs, right heart bypass model), and (3) the concomitant support of D-PATCH and aortic counterpulsation (CP) on the regional myocardial function of the residual LV wall (group 3, 6 dogs, right heart bypass model with ultrasonic piezoelectric crystals). In group 1, mean aortic pressure and cardiac output were increased 20-36% (p less than 0.01) and 17-50% (p less than 0.01) respectively, and mean left atrial pressure was decreased 16% (p less than 0.01) by D-PATCH assist. In group 2, under constant preload volume, afterload pressure and heart rate, tension time index (TTI) was decreased 21-26% (p less than 0.01) and myocardial oxygen consumption was also decreased 24-29% (p less than 0.001) by D-PATCH assist. In group 3, although peak LVP was increased by single D-PATCH assist, when heart was assisted concomitantly by D-PATCH and CP peak LVP was significantly decreased (18%, p less than 0.01). Percent LV segmental shortening was not increased by CP assist, but increased 143% (p less than 0.02) by D-PATCH assist. In conclusion, D-PATCH can improve the global LV function and myocardial metabolism of the ischemic failing heart, also improve the regional myocardial function of the residual LV wall. Thus, D-PATCH is effective for the salvage of ischemic myocardium while maintaining the global cardiac function.
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