Hemodynamic and metabolic effects of para- versus intraaortic counterpulsatile circulation supports.
Despite the success of intraaortic balloon counterpulsation, data on physiologic indices and optimal inflation/deflation timing control of chronic counterpulsation devices are unclear. This study explored the acute hemodynamic and metabolic efficacy of a novel 40-ml stroke volume paraaortic blood pump (PABP) versus a standard intraaortic balloon pump (IABP). Acute porcine model was used with eight pigs randomly divided into PABP (n = 4) and IABP (n = 4) groups. Hemodynamic and metabolic measurements were obtained with and without mechanical assistance. In one pig, the inflation/deflation control was adjusted to different settings, with corresponding performance indices measured. The PABP significantly improved classical counterpulsation indices (p ≤ 0.05) and achieved an average beneficial effect on these indices 1.5-3.5 times greater than that of the IABP. Classical metabolic indices (tension time index and endocardial viability ratio [EVR]), and indices new to chronic counterpulsation research (coronary perfusion, left ventricular stroke work (SW), and a newly derived EVR) were also used in assessment. Both IABP assistance and PABP assistance improved these physiologic indices, with a trend toward PABP superiority in reducing left ventricular SW (p = 0.08). An optimal PABP deflation timing occurs during systole (25 milliseconds after the R-wave) and can minimize coronary regurgitation.
Lu
Pong-Jeu
PJ
Department of Aeronautics and Astronautics, National Cheng Kung University, Tainan, Taiwan. pjlu@mail.ncku.edu.tw
Lin
Pao-Yen
PY
Yang
Chi-Fu Jeffrey
CF
Hung
Chun-Hao
CH
Chan
Ming-Yao
MY
Hsu
Tzu-Cheng
TC
D000818:Animals; D015908:Counterpulsation / Q000295:instrumentation*; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D023421:Models, Animal; D011474:Prosthesis Design; D034421:Sus scrofa