Abstract

Previous studies show that stimulated skeletal muscle wrapped around the heart or a blood pumping pouch can provide partial circulatory assistance. However, skeletal muscle is accustomed to pulling in direct tension, and power obtained from using the muscle in wraparound configurations is very inefficient. Therefore we have developed a new skeletal muscle-powered, linear-pull energy convertor for powering a wide range of implanted devices, including circulatory support blood pumps such as counterpulsation devices or complete prosthetic ventricles. This energy convertor system is powered by a skeletal muscle such as the latissimus dorsi, which is stimulated with a pulse generator. With the muscle left intact and in situ as much as possible, its insertion at the humerus is removed and reattached to a small-cylinder hydraulic energy convertor that is firmly attached to the ribs. Mechanical force in direct tension from the muscle is converted to high-pressure, low displacement; hydraulic energy (at approximately 200 psi). The output of this hydraulic energy convertor is connected by a small-diameter tube to a hydraulic actuator to drive the pusher plate of an implantable ventricular assist device located in the thoracic cavity or abdomen or another suitable blood pump. Preliminary in vitro tests from an engineering model of the Thoratec muscle-powered ventricular assist device show flow outputs of 5.2 L/min at a mean arterial pressure of 99 mm Hg. The muscle-powered ventricular assist device is a specific application designed to provide completely implantable circulatory support as an alternative to heart transplantation. It will enable patients to experience a quality of life free from batteries and the electrical power-conditioning hardware required with electromechanical systems.