title: Myocardial tolerance to mechanical actuation is affected by biomaterial characteristics.
abstract: Direct mechanical ventricular actuation (DMVA) uses a pressure regulated heart cup, fabricated from silicone rubber (SR) for mechanical massage of the heart. Because DMVA has demonstrated potential for long-term circulatory support, investigations are currently exploring the use of more durable materials for fabricating DMVA heart cups. This study assessed the acute effects of heart cups fabricated from SR versus polyurethane (PU) on the myocardium. Dogs (n - 18) received DMVA for 4 hr of ventricular fibrillation (VF) using either SR (n = 10) or PU (n = 8) cups. Microspheres were used to determine perfusion during sinus rhythm (control) and at 2 and 4 hr of support. After support, myocardial biopsies were assayed for high energy phosphate content. Results demonstrated that PU cups required relatively frequent adjustments in drive line parameters that were likely due to material softening during PU cup support. Both PU and SR cups achieved similar hemodynamics during 4 hr of support. Myocardial perfusion, however, demonstrated a marked hyperemia at 4 hr of PU versus SR cup support. Regional high energy phosphate content was significantly decreased in hearts supported by PU versus SR cups. These results suggest that the relatively compliant characteristics of SR materials are important for achieving effective DMVA support without injuring the myocardium.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Anstadt
authors.forename: R A
authors.initials: RA
authors.lastname: Perez-Tamayo
authors.forename: D M
authors.initials: DM
authors.lastname: Banit
authors.forename: H P
authors.initials: HP
authors.lastname: Walthall
authors.forename: R L
authors.initials: RL
authors.lastname: Cothran
authors.forename: S
authors.initials: S
authors.lastname: Abdel-Aleem
authors.forename: G L
authors.initials: GL
authors.lastname: Anstadt
authors.forename: P L
authors.initials: PL
authors.lastname: Jones
authors.forename: J E
authors.initials: JE
authors.lastname: Lowe
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects; D001698:Biomedical Engineering; D004285:Dogs; D004548:Elasticity; D005069:Evaluation Studies as Topic; D006321:Heart / Q000502:physiology*; D006353:Heart-Assist Devices / Q000009:adverse effects; D006439:Hemodynamics / Q000502:physiology; D008422:Materials Testing; D008863:Microspheres; D009206:Myocardium / Q000378:metabolism; D011140:Polyurethanes / Q000009:adverse effects; D012826:Silicone Elastomers / Q000009:adverse effects; D013314:Stress, Mechanical; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; D011140:Polyurethanes; D012826:Silicone Elastomers; D000255:Adenosine Triphosphate