Document Detail

Challenges in longer-term mechanical support of fontan circulation in sheep.
MedLine Citation:
PMID:  22210652     Owner:  NLM     Status:  In-Data-Review    
Single ventricle congenital heart defects are usually palliated with the end result of a Fontan circulation. Despite improving results, this circulation is still associated with long-term failure. We previously developed an animal model of mechanical cavopulmonary circulation support that was successful in the acute and mid-term period. In the current study, we evaluated longer support durations in five Western-breed sheep. Through a right thoracotomy we instituted mechanical support from the inferior vena cava to the pulmonary artery, using a Heartmate II axial flow pump (Thoratec Corp., Pleasanton, CA). Postoperatively, the animals were anticoagulated with heparin iv. Hemodynamics, pump flow, anticoagulation, and hepatic and renal function were monitored daily. All animals survived the operation. Signs of moderate liver and kidney injury in general reversed quickly. Two animals had a fatal pump thrombosis. When anticoagulation was effective, hemodynamics and pump flow were maintained to normal values. Effective anticoagulation was difficult to achieve because of the high variability in response to heparin. Survival up to 18 days was accomplished. This study is the longest reported survival of animals with a mechanically assisted cavopulmonary circulation. The performance of the Thoratec Heartmate II has been good, but the issue of effective anticoagulation has not yet been solved.
Lorenzo Boni; Takashi Sasaki; William T Ferrier; John T Yeung; Steven H Reichenbach; R Kirk Riemer; Olaf Reinhartz
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  58     ISSN:  1538-943X     ISO Abbreviation:  ASAIO J.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-4     Citation Subset:  IM    
*Department of Cardiothoracic Surgery, Division of Pediatric Cardiac Surgery, Stanford University, Stanford, California †Department of Medicine and Epidemiology, UC Davis School of Veterinary Medicine, Davis, California ‡Department of Research and Development, Thoratec Corporation, Pleasanton, California.
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