Document Detail


Prolonged total circulatory support using direct mechanical ventricular actuation.
MedLine Citation:
PMID:  8573857     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Direct mechanical ventricular actuation (DMVA) is a unique, non blood contacting method for biventricular cardiac assist. Although DMVA has successfully provided cardiac assist for more than 7 days in humans, with long-term survival, its potential for long-term circulatory support has not been adequately investigated. DMVA has not been studied in the large ruminants commonly used to evaluate support devices. To develop a large animal experimental model of prolonged total circulatory support using DMVA, Suffolk sheep (n = 10) underwent sterile instrumentation for hemodynamic and chemistry monitoring. After baseline values were obtained, a left lateral thoracotomy and pericardotomy were performed. Upon electrical ventricular fibrillation (VF), DMVA was begun and the thoracotomy closed. Total circulatory support was continued until mean arterial pressure (MAP) persisted below 50% of the baseline value for more than 1 hr, with a goal of 7 days' support. Mean duration (plus or minus the standard deviation [SD]) of circulatory support was 65.9 +/- 56.8 hr (range, 10-168 hr). Pressors were not used during DMVA support. The subject supported for the maximal time (7 days) was defibrillated into sinus rhythm. No CK-MB fraction was greater than 1%, suggesting that DMVA, even with prolonged application during VF, does not result in myocardial injury. Blood urea nitrogen and creatinine levels indicate renal function was preserved. The model described represents the longest period any animal has been supported in VF using DMVA. This new model will be useful in determining what limitations, if any, exist to the prolonged use of DMVA for circulatory support.
Authors:
R A Perez-Tamayo; M P Anstadt; R L Cothran; R J Reisinger; D I Schenkman; C Hulette; K A Reimer; G L Anstadt; J E Lowe
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  41     ISSN:  1058-2916     ISO Abbreviation:  ASAIO J.     Publication Date:    1995 Jul-Sep
Date Detail:
Created Date:  1996-03-12     Completed Date:  1996-03-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  M512-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Biomechanics
Blood Pressure
Blood Urea Nitrogen
Creatine Kinase / blood
Creatinine / blood
Equipment Design
Evaluation Studies as Topic
Heart-Assist Devices* / adverse effects
Hemodynamics
Isoenzymes
Kidney / physiology
Sheep
Time Factors
Grant Support
ID/Acronym/Agency:
F32-HL08705/HL/NHLBI NIH HHS; R01-HL48618/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Isoenzymes; 60-27-5/Creatinine; EC 2.7.3.2/Creatine Kinase

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


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