A comparative evaluation of pulmonary artery balloon counterpulsation and a centrifugal flow pump in an experimental model of right ventricular infarction.
To compare the efficiency of pulmonary artery balloon counterpulsation and a centrifugal flow pump in reversing the hemodynamic consequences of acute right-sided heart failure, we employed both devices in 14 Yorkshire pigs in which right ventricular infarction was created via surgical ligation of branches of the right coronary artery. Pulmonary artery balloon counterpulsation improved some of the indicators of right heart failure, as manifested by significantly decreased right atrial pressure and increased mean systemic blood pressure. In contrast, the centrifugal flow pump consistently and significantly reversed all of the hemodynamic consequences of right ventricular infarction. In comparison to pulmonary artery balloon counterpulsation, the centrifugal flow pump resulted in lower right atrial pressures (p=0.020), lower mean pulmonary pressures (p less than 0.0001), increased left atrial pressures (p=0.026), increased cardiac output (p less than 0.0001), and increased mean systemic blood pressures (p less than 0.0001). Possible mechanisms to explain the superiority of the centrifugal flow pump include better hemodynamic unloading of the failing myocardium and independence from right ventricular output.
Departments of Medicine, Walter Reed Army Medical Center, Washington, DC.
A J
AJ
Taylor
F H
FH
Edwards
M G
MG
Macon
B
B
Worley
G M
GM
Graeber
D000818:Animals; D015908:Counterpulsation / Q000295:instrumentation*; D004867:Equipment Design; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices; D006439:Hemodynamics; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery; D013552:Swine