Document Detail

Left-ventricular unloading with a new pulsatile assist device: the HIA-VAD system and its influence on myocardial stunning.
MedLine Citation:
PMID:  8775855     Owner:  NLM     Status:  MEDLINE    
To assess the mechanical unloading properties of a new pneumatic cardiac assist device (60 ml Medos HIA-VAD) and its possible influence on recovery from myocardial stunning we performed a study in 12 anaesthetized sheep. After left thoracotomy measuring transducers were placed and the assist device connected between the left-atrial appendage and the descending thoracic aorta. Global hemodynamics were measured before and after unloading was performed. Myocardial stunning was induced by transient occlusion of a coronary artery for 15 minutes and regional myocardial wall thickening was measured. A group without unloading served as controls (group I, n = 4). In a second group unloading was performed during the last ten minutes of ischemia (group II, n = 4) and in a third group unloading was performed for 30 minutes starting after ten minutes of reperfusion (group III, n = 4). After starting the Medos HIA-VAD, significant unloading could be demonstrated: left-ventricular dP/dtmax decreased significantly (p < 0.05) to 54% and 61% in groups II and III and left-atrial pressure to 50% and 71%, respectively. Systolic and mean arterial pressure did not change significantly (p > 0.05), while the diastolic pressure increased (p < 0.05) to 134% and 138% in groups II and III. After mechanical unloading whether during ischemia or during reperfusion systolic wall thickening in the postischemic area recovered to 103% and 92% of preischemic control in groups II and III, respectively. Recovery was incomplete in the non-unloaded controls (76%) (p < 0.05 versus groups II and III). Post-ejection thickening, a diastolic measure of stunning, diminished significantly after unloading in both protocols (p < 0.05 for groups II and III versus group I). We conclude that mechanical unloading with the 60 ml Medos HIA-VAD significantly improves recovery from myocardial stunning.
F R Waldenberger; E Pongo; B Meyns; W Flameng
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  43     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-12-16     Completed Date:  1996-12-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  313-9     Citation Subset:  IM; S    
Department of Cardiac Surgery and Centre for Experimental Surgery and Anesthesiology, Katholieke Universiteit, Leuven, Belgium.
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MeSH Terms
Evaluation Studies as Topic
Heart-Assist Devices*
Myocardial Reperfusion Injury / prevention & control
Myocardial Stunning / pathology,  physiopathology*,  therapy
Myocardium / pathology

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