title: Shear stress, energy losses, and costs: a resolved dilemma of pulsatile cardiac assist devices.
abstract: Cardiac assist devices (CAD) cause endothelial dysfunction with considerable morbidity. Employment of pulsatile CAD remains controversial due to inadequate perfusion curves and costs. Alternatively, we are proposing a new concept of pulsatile CAD based on a fundamental revision of the entire circulatory system in correspondence with the physiopathology and law of physics. It concerns a double lumen disposable tube device that could be adapted to conventional cardiopulmonary bypass (CPB) and/or CAD, for inducing a homogenous, downstream pulsatile perfusion mode with lower energy losses. In this study, the device's prototypes were tested in a simulated conventional pediatric CPB circuit for energy losses and as a left ventricular assist device (LVAD) in ischemic piglets model for endothelial shear stress (ESS) evaluations. In conclusion and according to the study results the pulsatile tube was successfully capable of transforming a conventional CPB and/or CAD steady flow into a pulsatile perfusion mode, with nearly physiologic pulse pressure and lower energy losses. This represents a cost-effective promising method with low mortality and morbidity, especially in fragile cardiac patients.
authors: Laboratory of Biosurgical Research (Alain Carpentier Foundation), Pompidou Hospital, University Paris Descartes, 56 Rue Leblanc, 75015 Paris, France ; Division of Cardiology and the Key Laboratory on Assisted Circulation, Ministry of Health of China, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors: Sayed
authors: S
authors: Nour
authors: Division of Cardiology and the Key Laboratory on Assisted Circulation, Ministry of Health of China, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors: Jia
authors: J
authors: Liu
authors: Division of Cardiology and the Key Laboratory on Assisted Circulation, Ministry of Health of China, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors: Gang
authors: G
authors: Dai
authors: Laboratory of Biosurgical Research (Alain Carpentier Foundation), Pompidou Hospital, University Paris Descartes, 56 Rue Leblanc, 75015 Paris, France.
authors: Daniel
authors: D
authors: Carbognani
authors: Division of Cardiology and the Key Laboratory on Assisted Circulation, Ministry of Health of China, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors: Daya
authors: D
authors: Yang
authors: Division of Cardiology and the Key Laboratory on Assisted Circulation, Ministry of Health of China, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors: Guifu
authors: G
authors: Wu
authors: Division of Cardiology and the Key Laboratory on Assisted Circulation, Ministry of Health of China, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors: Qinmei
authors: Q
authors: Wang
authors: Laboratory of Biosurgical Research (Alain Carpentier Foundation), Pompidou Hospital, University Paris Descartes, 56 Rue Leblanc, 75015 Paris, France.
authors: Juan Carlos
authors: JC
authors: Chachques
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D001794:Blood Pressure / Q000502:physiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002315:Cardiopulmonary Bypass; D004867:Equipment Design; D005260:Female; D006353:Heart-Assist Devices; D008297:Male; D011674:Pulse; D013314:Stress, Mechanical; D013552:Swine