| Ascending aorta outflow graft location and pulsatile ventricular assist provide optimal hemodynamic support in an adult mock circulation. | |
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MedLine Citation:
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PMID: 16048479 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Although continuous flow (CF) and pulsatile flow (PF) ventricular assist devices (VADs) are being clinically used, their effects on aortic blood flow, as a measure of overall blood distribution, remain unclear. In acute VAD support animal experiments, our group has described a zone of turbulent mixing in the aortic arch. The objective of this study was to confirm this finding in the controlled setting of an adult mock circulation, simulating ventricular pathophysiologic states (normal and failing ventricle). CF and PF flow VADs were connected to ventricular apical inflow and ascending aorta (AA) or descending aorta (DA) outflow cannulae. Cardiovascular pressure and flow waveforms were recorded at varying levels of VAD bypass resulting in four test conditions: (i) CF-AA; (ii) CF-DA; (iii) PF-AA; and (iv) PF-DA. Confirming the animal data, no differences in mean aortic flow between CF and PF VADs were found, and significantly lower mean aortic arch flow with DA cannulation was noted. Mean aortic root flow decreased with increasing VAD bypass flow. As in the animal studies, despite similar mean flow rates, significant differences in waveform morphology were observed for AA and DA outflow graft locations and varying levels of VAD bypass. At 100% VAD support in the failing heart, PF restored waveform pulsatility to normal baseline while CF resulted in little pulsatility. These results confirm our earlier findings in the animal model, suggesting that outflow graft location may have a significant effect on aortic blood flow distribution. The long-term implications of these findings are being examined in ongoing studies. |
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Authors:
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Kenneth N Litwak; Steven C Koenig; Rolando C Cheng; Guruprasad A Giridharan; Kevin J Gillars; George M Pantalos |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Artificial organs Volume: 29 ISSN: 0160-564X ISO Abbreviation: Artif Organs Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-07-28 Completed Date: 2005-12-07 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7802778 Medline TA: Artif Organs Country: United States |
Other Details:
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Languages: eng Pagination: 629-35 Citation Subset: IM |
Affiliation:
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Jewish Hospital Heart and Lung Institute, University of Louisville, Department of Surgery, Louisville KY 40202, USA. kenneth.litwak@louisville.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aorta / physiology Blood Flow Velocity Blood Vessel Prosthesis* Heart-Assist Devices* Hemodynamics Hemorheology* Humans Models, Cardiovascular Pulsatile Flow / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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