Abstract:
:Excessive left ventricular (LV) volume unloading can affect right ventricular (RV) function by causing a leftward shift of the interventricular septum in patients with mitral regurgitation (MR) receiving left ventricular assist device (LVAD) support. Optimal settings for the LVAD should be chosen to appropriately control the MR without causing RV dysfunction. In this study, we assessed the utility of our electrocardiogram-synchronized rotational speed (RS) modulation system along with a continuous-flow LVAD in a goat model of MR. We implanted EVAHEART devices after left thoracotomy in six adult goats weighing 66.4 ± 10.7 kg. Severe MR was induced through inflation of a temporary inferior vena cava filter placed within the mitral valve. We evaluated total flow (TF; the sum of aortic flow and pump flow [PF]), RV fractional area change (RVFAC) calculated by echocardiography, left atrial pressure (LAP), LV end-diastolic pressure (LVEDP), LV end-diastolic volume (LVEDV), and LV stroke work (LVSW) with a bypass rate (PF divided by TF) of 100% under four conditions: circuit-clamp, continuous mode, co-pulse mode (increased RS during systole), and counter-pulse mode (increased RS during diastole). TF tended to be higher in the counter-pulse mode. Moreover, RVFAC was significantly higher in the counter-pulse mode than in the co-pulse mode, whereas LAP was significantly lower in all driving modes than in the circuit-clamp condition. Furthermore, LVEDP, LVEDV, and LVSW were significantly lower in the counter-pulse mode than in the circuit-clamp condition. The counter-pulse mode of our RS modulation system used with a continuous-flow LVAD may offer favorable control of MR while minimizing RV dysfunction.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Naito N,Nishimura T,Takewa Y,Kishimoto S,Date K,Umeki A,Ando M,Ono M,Tatsumi Edoi
10.1111/aor.12702subject
Has Abstractpub_date
2016-11-01 00:00:00pages
1039-1045issue
11eissn
0160-564Xissn
1525-1594journal_volume
40pub_type
杂志文章abstract::Thirty-five patients undergoing open-heart surgery are reported. Cardiac index, mean arterial pressure, oxygen consumption, lactate, pyruvate, and lactate excess in the blood were measured. An inverse correlation of arterial pressure with oxygen consumption and lactate excess was found during perfusion. Comparison of ...
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