Acute experimental study of Abiomed BVS5000 as a V-A bypass to cardiogenic shock models.
OBJECTIVE
Abiomed BVS5000 is generally used as a ventricular assist device, and there have been no reports of its application to a veno-arterial bypass (V-A bypass). In the present study, we developed a new V-A bypass system using this pump and examined its usefulness experimentally.


METHODS
Pigs (n=21; 37.4+/-2.2 kg) with cardiogenic shock were divided into the following three groups: (1) Abiomed group (Abiomed BVS5000); (2) nonpulsatile pump (NP)+intra-aortic balloon pump (IABP) group (centrifugal pump and IABP); and (3) NP group. In all three groups, assisted circulation using the pumps was performed for 3 h after the shock. Hemodynamic data and blood specimens were measured before and immediately after the shock, and again at 1, 2, and 3 h after. The individual variations were reduced by evaluation of the measured value/preshock value ratio, not by evaluation of the absolute values.


RESULTS
The coronary arterial blood flows at 3 h after the shock were significantly larger in the Abiomed and NP+IABP groups than in the NP group (1.32+/-0.34 and 1.24+/-0.05 vs. 1.05+/-0.11, P<0.05), and the renal arterial and renal cortical tissue blood flows were significantly larger in the Abiomed group than in the NP+IABP and NP groups (renal artery: 1.30+/-0.17 vs. 0.89+/-0.20 and 0.68+/-0.10, P<0.05; renal cortical tissue: 0.74+/-0.25 vs. 0.62+/-0.05 and 0.43+/-0.18, P<0.05). The lactate/pyruvate ratios were significantly lower in the Abiomed groups than in the NP group (25.2+/-1.6 vs. 36.0+/-3.1, P<0.05).


CONCLUSIONS
The results suggest that a V-A bypass using an Abiomed BVS5000 is a useful treatment for organ blood flow redistribution after shock.
Taoka
Makoto
M
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D006353:Heart-Assist Devices; D006439:Hemodynamics; D007423:Intra-Aortic Balloon Pumping; D011673:Pulsatile Flow; D012770:Shock, Cardiogenic / Q000503:physiopathology / Q000628:therapy*; D013552:Swine