title: Improved hemodynamics with a novel miniaturized intra-aortic axial flow pump in a porcine model of acute left ventricular dysfunction.
abstract: Currently, long-term mechanical circulatory support (MCS) is limited to large, complex devices that require invasive, high-risk surgical implantation. These devices are mainly used in patients with late stage heart failure (HF). We are developing a novel percutaneous intra-aortic micro-axial fluid entrainment pump intended for long-term MCS in patients with earlier stage HF. This study examined the pump's hemodynamic effects in a porcine model of acute HF. In three porcine experiments, the pump was deployed in the thoracic aorta by standard cardiac catheterization techniques and was anchored with self-expanding struts. Acute cardiac dysfunction was induced by infusing esmolol continuously. Pump support increased cardiac output (+10.4%), stroke volume (+8.9%), and ejection fraction (+10.8%) while decreasing cardiac stroke work (-10.8%) and afterload (-22.7%). Furthermore, pump support significantly enhanced renal perfusion through sustained increases in both renal artery flow (+36.4%) and pressure (+73.6%). In a porcine model of acute HF, the catheter-based intra-aortic fluid entrainment pump improved hemodynamics and renal perfusion. These results suggest that the pump could improve HF outcomes and patients' quality of life by resting the heart, promoting reverse remodeling, and augmenting end-organ perfusion. Furthermore, the enhanced renal perfusion may help disrupt the cardiorenal syndrome cycle and improve HF treatment.
authors: Department of Cardiopulmonary Transplantation and Center for Cardiac Support, Texas Heart Institute, Houston, Texas, USA.
authors: Farshad Raissi
authors: FR
authors: Shabari
authors: Joggy
authors: J
authors: George
authors: Michael P
authors: MP
authors: Cuchiara
authors: Robert J
authors: RJ
authors: Langsner
authors: Jason J
authors: JJ
authors: Heuring
authors: William E
authors: WE
authors: Cohn
authors: Benjamin A
authors: BA
authors: Hertzog
authors: Reynolds
authors: R
authors: Delgado
mesh_terms: D000208:Acute Disease; D000818:Animals; D001011:Aorta / Q000503:physiopathology / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D004195:Disease Models, Animal; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology*; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D011474:Prosthesis Design / Q000379:methods*; D013552:Swine; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000601:surgery*; D016277:Ventricular Function, Left / Q000502:physiology*