Document Detail


Primary in-series palliation of hypoplastic left heart syndrome with mechanical lung assist in neonatal pigs.
MedLine Citation:
PMID:  19812479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Less than optimal outcomes for hypoplastic left heart syndrome may be related to unstable in-parallel circulation. Mechanical lung assist by (1) superior vena cava to right atrium pump with oxygenation (oxygenator assist), or (2) superior vena cava to pulmonary artery pump (pump assist) may permit successful neonatal in-series palliation. Nineteen 15-day-old piglets underwent single ventricle and bidirectional cavopulmonary shunt (BCPC) creation without mechanical lung assist (n = 8), with pump assist (n = 5), or with oxygenator assist (n = 6). Baseline hemodynamic measurements were not different between groups. Median survival for the cavopulmonary shunt alone, pump assist, and oxygenator assist groups was 28, 180, and 180 minutes, respectively (p = 0.0006). No differences in arterial oxygen concentration or bicarbonate levels were detected. Arterial carbon dioxide (p < or = 0.007) was higher in the cavopulmonary shunt alone versus lung assist groups. Cavopulmonary shunt alone animals had decreased mean arterial pressure (p < 0.02) and cerebral perfusion pressure (p = 0.029) and elevated left atrial pressure compared with lung assist groups (p < 0.05). This data demonstrates creation of a novel translational neonatal BCPC model in which mechanical lung assist augments survival. Early BCPC death was related to poor ventricular function and an inability to ventilate, issues that were improved with both types of lung assist.
Authors:
Sandra L Merklinger; Osami Honjo; Osman O Al-Radi; John Poe; Jian Wang; Norihiko Oka; Glen S Van Arsdell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  55     ISSN:  1538-943X     ISO Abbreviation:  ASAIO J.     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2009-11-10     Completed Date:  2010-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  620-5     Citation Subset:  IM    
Affiliation:
The Labatt Family Heart Center, The Hospital for Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Heart Bypass, Right
Heart-Assist Devices*
Hemodynamics
Hypoplastic Left Heart Syndrome / surgery*
Male
Respiration, Artificial / adverse effects,  instrumentation,  methods*
Swine

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


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