Experimental testing of a new left ventricular assist device--the microdiagonal blood pump.
All existing ventricular assist devices are associated with a considerable number of serious complications. This article reports on the first animal tests with a newly developed microdiagonal blood pump (MDP). Six adult female sheep weighing 80 to 90 kg underwent implantation of the microdiagonal blood pump. The inflow and outflow conduits were anastomosed to the left atrium and the descending aorta. Pump flow was adjusted to 2-3 L/minute. Hemodynamic and echocardiographic data, as well as blood samples, were measured over the entire test period of 7 days. All internal organs and the pump were explanted for thorough examination at the end of the trial. Mean arterial (range 88.5 +/- 13.1-103.7 +/- 10.7 mm Hg) and mean pulmonary arterial (18.3 +/- 2.7-21.6 +/- 20.5 mm Hg) pressures, as well as the pulmonary capillary wedge pressure (14.2 +/- 3.0 - 16.6 +/- 4.0 mm Hg), remained stable during the whole test period. Cardiac output (4.9 +/- 0.7 --> 3.2 +/- 0.5 L/minute) decreased postoperatively caused by partial unloading of the heart. Left ventricular end diastolic (4.1 +/- 0.5 --> 3.6 +/- 0.3 cm) and end systolic (3.2 +/- 0.4 --> 2.8 +/- 0.5 cm) diameters, as well as the ejection fraction (57 +/- 9 --> 42 +/- 5%), decreased after MDP implantation and did not change during the test period. Mean number of platelets (428 +/- 54 --> 286 +/- 66 x 10(3)/microL) and hemoglobin (9.8 +/- 1.3 --> 6.3 +/- 0.8 g/dL) decreased perioperatively because of surgical reasons and increased continuously in the postoperative course (platelet count and hemoglobin on day 7:441 +/- 74 x 10(3)/microL and 7.2 +/- 1.1 g/dL, respectively). Free hemoglobin was not enhanced in the postoperative course (mean value during the test period: 18.8 mmoL/L). Histologic examination of the organs did not demonstrate any infarctions of internal organs other than typical operative sequelae such as chronic pericarditis and some degree of atelectasis of the left lungs. These results demonstrate that the microdiagonal pump may be a promising alternative to the currently used ventricular assist devices, if long-term trials support these results.
Christiansen
Stefan
S
Department of Cardiothoracic Surgery, University of Aachen, Pauwelsstr. 30, 52074 Aachen, Germany.
Demircan
Lütfü
L
Kwant
Paul B
PB
Akdis
Mustafa
M
Rex
Steffen
S
Buhre
Wolfgang
W
Langebartels
Georg
G
Kuruc
Norbert
N
Nikolin
Stefan
S
Reul
Helmut
H
Autschbach
Rüdiger
R
D000818:Animals; D001794:Blood Pressure; D002302:Cardiac Output; D004452:Echocardiography; D005260:Female; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D010976:Platelet Count; D011184:Postoperative Period; D011474:Prosthesis Design; D012756:Sheep; D013908:Thoracotomy; D013997:Time Factors; D016277:Ventricular Function, Left
D006454:Hemoglobins