Isolation of skeletal muscle for biomechanical circulatory assist.

T ransfer of pedicled muscle flaps in humans to adjacent or distant anatomic sites is commonplace in modern surgery. Such transfers have been used for soft tissue coverage of exposed vital structures, as aids to healing in compromised sites such as osteomyelitic and irradiated wounds, and for contour and form restoration following surgical ablation.lS2 Of particular relevance to the current discussion is the extensive historical experience in the transfer of muscle units for functional rehabilitation, which is chronicled primarily in the orthopedic and reconstructive literature. The critical difference between muscle unit transfers for wound coverage or contour restoration and transfers accomplished for functional restoration is that the latter requires the additional preservation of motor neural relationships as well as the vascular integrity essential for simple viability of the transferred unit. This experience in functional transfers has served as the foundation for the adaptation of essentially similar techniques to cardiomyoplasty with the obvious addition of electrical pacing to the transferred muscle.