Document Detail


Evaluation of an extraaortic counterpulsation device in severe cardiac failure.
MedLine Citation:
PMID:  1728239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A valveless, single-orifice polyurethane ventricle with a maximum stroke volume of 60 mL was implanted on the brachiocephalic artery just above the aortic arch in sheep (n = 14) to act as an extraaortic counterpulsation device. In parallel, an intraaortic balloon was placed in the descending thoracic aorta. Both devices were pneumatically driven with an intraaortic balloon pump console that was gated by the electrocardiogram to provide aortic diastolic augmentation at a stroke volume of 40 mL. To compare the efficacy of counterpulsation for each device during severe cardiac failure, biventricular block was induced by continuous infusion of esmolol (100 to 600 micrograms.kg-1.min-1), titrated to reduce aortic flow and pressure to less than 75% of baseline. Pulsatile coronary and aortic flows were recorded with ultrasonic flow probes placed around their respective vessels. Aortic root and left ventricular pressures were recorded using micromanometers. The enhancement of hemodynamic variables for both devices were compared for optimal timing conditions, which were defined as inflation set just before the dicrotic notch and deflation bordering on isovolumetric systole. The extraaortic counterpulsation device was able to significantly augment aortic and coronary flows while simultaneously decreasing left ventricular tension time index and aortic end-diastolic pressure (p less than 0.02). The intraarotic balloon pump was able to significantly reduce only tension time index (p less than 0.002) to a lesser extent that the extraaortic counterpulsation device. All analysis was performed with the paired-samples t test. The extraaortic counterpulsation device greatly improves the myocardial oxygen supply-consumption ratio of the left ventricle by increasing diastolic coronary flow and reducing left ventricular wall tension during systole.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J A Zelano; W Ko; R Lazzaro; W D Lazenby; S Topaz; W J Kolff; O W Isom; K H Krieger
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  53     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-01-28     Completed Date:  1992-01-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  30-6; discussion 36-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, New York Hospital-Cornell Medical Center, NY 10021.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiac Output, Low / physiopathology,  surgery*
Counterpulsation / instrumentation*
Evaluation Studies as Topic
Heart-Assist Devices
Hemodynamics / physiology
Intra-Aortic Balloon Pumping
Polyurethanes
Prostheses and Implants
Sheep
Stroke Volume / physiology
Chemical
Reg. No./Substance:
0/Polyurethanes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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