- Email: [email protected]
EFFECTS OF A NOVEL IMPLANTABLE COUNTERPULSATION ASSIST DEVICE ON LEFT VENTRICULAR MECHANOENERGETICS: COMPARISON WITH THE INTRA-AORTIC BALLOON PUMP IN A PORCINE MODEL OF ACUTE HEART FAILURE
1386 JACC April 5, 2016 Volume 67, Issue 13
Heart Failure and Cardiomyopathies EFFECTS OF A NOVEL IMPLANTABLE COUNTERPULSATION ASSIST DEVICE ON LEFT VENTRICULAR MECHANOENERGETICS: COMPARISON WITH THE INTRA-AORTIC BALLOON PUMP IN A PORCINE MODEL OF ACUTE HEART FAILURE Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 3:45 p.m.-4:30 p.m. Session Title: Heart Failure and Cardiomyopathies: Surgical Approaches/LVADs Abstract Category: 27. Heart Failure and Cardiomyopathies: Therapy Presentation Number: 1137-080 Authors: Christos Kontogiannis, Yiannis Nanas, Smaragdi Sarchosi, Christos Kapelios, Sotiris Marinakis, Dionysios Aravantinos, Ioannis Tachliabouris, Christos Charitos, Despina Perrea, John Nanas, Konstantinos Malliaras, University of Athens, School of Medicine, Athens, Greece
Background: We have developed a novel implantable counterpulsation left ventricular (LV) assist device, the Pressure-Unloading Left Ventricular Assist Device (PULVAD). We compared the effects of PULVAD support on LV mechanoenergetics to those induced by the intraaortic balloon pump (IABP) in a porcine model of acute heart failure (AHF). Methods: PULVAD comprises a pneumatically-driven pumping chamber implanted in the thoracic cavity and connected to the ascending aorta. The pump is ECG-synchronized to operate through inflation of the device air space during diastole (injecting blood into the aorta), and deflation just prior and during systole (sucking blood from the aorta into the device blood sac). In 6 farm pigs, instrumented with Millar catheter and sonomicrometry crystals, AHF was induced by ligation of the left anterior descending artery. PULVAD was implanted in the thoracic cavity and connected to the ascending aorta; an IABP was inserted in the descending aorta. Both devices were driven by the Arrow Autocat 2 Wave IABP system console and were ECG-synchronized to provide LV pressure unloading along with aortic diastolic pressure augmentation. Traditional hemodynamics, indices of LV energy consumption and indices of LV mechanical performance were measured without and after 1 minute of PULVAD or IABP support.
Results: PULVAD support induced profound reduction of LV afterload, significantly greater compared to IABP (relative decrease in systolic arterial pressure: -16% vs -6%; relative decrease in end-diastolic arterial pressure: -33% vs -9%). PULVAD support induced significantly greater decrease in LV energy consumption compared to IABP (relative decrease in stroke work: -19% vs -6%). PULVAD support resulted in significantly improved LV mechanical performance compared to IABP (relative increase in ejection fraction: +23% vs +6%, relative increase in cardiac output: +20% vs +7%).
Conclusions: PULVAD, a novel implantable counterpulsation LVAD, produces significantly augmented benefits in LV mechanoenergetics (greater reduction in LV afterload and energy consumption, and greater improvement in LV mechanical performance) compared to the IABP in a porcine model of AHF.
Heart Failure and Cardiomyopathies EFFECTS OF A NOVEL IMPLANTABLE COUNTERPULSATION ASSIST DEVICE ON LEFT VENTRICULAR MECHANOENERGETICS: COMPARISON WITH THE INTRA-AORTIC BALLOON PUMP IN A PORCINE MODEL OF ACUTE HEART FAILURE Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 3:45 p.m.-4:30 p.m. Session Title: Heart Failure and Cardiomyopathies: Surgical Approaches/LVADs Abstract Category: 27. Heart Failure and Cardiomyopathies: Therapy Presentation Number: 1137-080 Authors: Christos Kontogiannis, Yiannis Nanas, Smaragdi Sarchosi, Christos Kapelios, Sotiris Marinakis, Dionysios Aravantinos, Ioannis Tachliabouris, Christos Charitos, Despina Perrea, John Nanas, Konstantinos Malliaras, University of Athens, School of Medicine, Athens, Greece
Background: We have developed a novel implantable counterpulsation left ventricular (LV) assist device, the Pressure-Unloading Left Ventricular Assist Device (PULVAD). We compared the effects of PULVAD support on LV mechanoenergetics to those induced by the intraaortic balloon pump (IABP) in a porcine model of acute heart failure (AHF). Methods: PULVAD comprises a pneumatically-driven pumping chamber implanted in the thoracic cavity and connected to the ascending aorta. The pump is ECG-synchronized to operate through inflation of the device air space during diastole (injecting blood into the aorta), and deflation just prior and during systole (sucking blood from the aorta into the device blood sac). In 6 farm pigs, instrumented with Millar catheter and sonomicrometry crystals, AHF was induced by ligation of the left anterior descending artery. PULVAD was implanted in the thoracic cavity and connected to the ascending aorta; an IABP was inserted in the descending aorta. Both devices were driven by the Arrow Autocat 2 Wave IABP system console and were ECG-synchronized to provide LV pressure unloading along with aortic diastolic pressure augmentation. Traditional hemodynamics, indices of LV energy consumption and indices of LV mechanical performance were measured without and after 1 minute of PULVAD or IABP support.
Results: PULVAD support induced profound reduction of LV afterload, significantly greater compared to IABP (relative decrease in systolic arterial pressure: -16% vs -6%; relative decrease in end-diastolic arterial pressure: -33% vs -9%). PULVAD support induced significantly greater decrease in LV energy consumption compared to IABP (relative decrease in stroke work: -19% vs -6%). PULVAD support resulted in significantly improved LV mechanical performance compared to IABP (relative increase in ejection fraction: +23% vs +6%, relative increase in cardiac output: +20% vs +7%).
Conclusions: PULVAD, a novel implantable counterpulsation LVAD, produces significantly augmented benefits in LV mechanoenergetics (greater reduction in LV afterload and energy consumption, and greater improvement in LV mechanical performance) compared to the IABP in a porcine model of AHF.