Development of a new circulatory assist method with the combined effects of intra-aortic balloon pumping and counter pulsation. First report.
Current circulatory assist methods, such as intra-aortic balloon pumping (IABP), are not always adequate to save acute circulatory failure patients. Therefore, a stronger, percutaneously accessible method is required. We found that the combination of IABP and CP generated a profound circulatory assist effect, and we have consequently developed a new assist system in this study. A sac type blood pump with a volume of 20 ml and a single port without a valve, was developed for CP. In the mock circulatory test, a 20 ml stroke volume was obtained using a cannula with a 5 mm diameter under the following driving conditions: air pressure = 200/-100 mmHg; S/D = 50%; pulse rate = 100 bpm. In vivo experiments were performed using four mongrel dogs with body weights of 12-20 kg. A cannula for CP was inserted via the brachial artery or subclavian artery into the aortic root. The pump flow (PF), coronary artery flow (CF), renal arterial flow (RF), and aortic pressure (AP) were measured, and the combined effects of IABP and CP were compared with their individual effects. In the most effective case, a marked increase in diastolic AP (60%), cardiac output (40%), and CF (100%) was obtained by the combination of IABP and CP, which produced a remarkable effect compared with the single use of IABP and CP. There was no negative effect on RF by this assist method. As this new circulatory support system has many circulatory assist effects, and is percutaneously accessible, it will be available for clinical use.
Imanishi
K
K
Department of Cardiovascular Surgery, Tokyo Women's Medical College School Hospital, Japan.
Imachi
K
K
Abe
Y
Y
Chinzei
T
T
Mabuchi
K
K
Fujimasa
I
I
Atsumi
K
K
Suma
K
K
D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D015908:Counterpulsation / Q000295:instrumentation*; D004285:Dogs; D004562:Electrocardiography; D004867:Equipment Design; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D008955:Models, Cardiovascular; D013318:Stroke Volume / Q000502:physiology*