Dynamic patch artificial myocardium; effects on the residual myocardial function.
Dynamic patch artificial myocardium (D-PATCH) has been developed to replace the damaged left ventricular (LV) wall in severe cardiogenic shock patients with a massive myocardial infarction. This study was undertaken to demonstrate the effects of (1) single D-PATCH support on the global cardiac function (group 1, 12 dogs, whole heart model), (2) single D-PATCH support on the LV function and myocardial metabolism (group 2, 6 dogs, right heart bypass model), and (3) the concomitant support of D-PATCH and aortic counterpulsation (CP) on the regional myocardial function of the residual LV wall (group 3, 6 dogs, right heart bypass model with ultrasonic piezoelectric crystals). In group 1, mean aortic pressure and cardiac output were increased 20-36% (p less than 0.01) and 17-50% (p less than 0.01) respectively, and mean left atrial pressure was decreased 16% (p less than 0.01) by D-PATCH assist. In group 2, under constant preload volume, afterload pressure and heart rate, tension time index (TTI) was decreased 21-26% (p less than 0.01) and myocardial oxygen consumption was also decreased 24-29% (p less than 0.001) by D-PATCH assist. In group 3, although peak LVP was increased by single D-PATCH assist, when heart was assisted concomitantly by D-PATCH and CP peak LVP was significantly decreased (18%, p less than 0.01). Percent LV segmental shortening was not increased by CP assist, but increased 143% (p less than 0.02) by D-PATCH assist. In conclusion, D-PATCH can improve the global LV function and myocardial metabolism of the ischemic failing heart, also improve the regional myocardial function of the residual LV wall. Thus, D-PATCH is effective for the salvage of ischemic myocardium while maintaining the global cardiac function.
D000818:Animals; D001794:Blood Pressure; D002302:Cardiac Output; D002315:Cardiopulmonary Bypass; D003326:Coronary Circulation; D004285:Dogs; D004562:Electrocardiography; D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery; D006352:Heart Ventricles / Q000503:physiopathology; D006354:Heart, Artificial; D006439:Hemodynamics; D009203:Myocardial Infarction / Q000150:complications; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption; D011093:Polyethylene Terephthalates; D012770:Shock, Cardiogenic / Q000503:physiopathology* / Q000601:surgery; D013318:Stroke Volume
D011093:Polyethylene Terephthalates