title: Novel control system to prevent right ventricular failure induced by rotary blood pump.
abstract: Right ventricular (RV) failure is a potentially fatal complication after treatment with a left ventricular assist device (LVAD). Ventricular septal shift caused by such devices is an important factor in the progress of RV dysfunction. We developed a control system for a rotary blood pump that can change rotational speed (RS) in synchrony with the cardiac cycle. We postulated that decreasing systolic RS using this system would alter ventricular septal movement and thus prevent RV failure. We implanted the EVAHEART ventricular assist device into seven adult goats weighing 54.1 ± 2.1 kg and induced acute bi-ventricular dysfunction by coronary embolization. Left and RV pressure was monitored, and ventricular septal movement was echocardiographically determined. We evaluated circuit-clamp mode as the control condition, as well as continuous and counter-pulse modes, both with full bypass. As a result, a leftward ventricular septal shift occurred in continuous and counter-pulse modes. The septal shift was corrected as a result of decreased RS during the systolic phase in counter-pulse mode. RV fractional area change improved in counter-pulse (59.0 ± 4.6%) compared with continuous (44.7 ± 4.0%) mode. In conclusion, decreased RS delivered during the systolic phase using the counter-pulse mode of our new system holds promise for the clinical correction of ventricular septal shift resulting from a LVAD and might confer a benefit upon RV function.
authors: Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan, a_mamoru@mbn.nifty.com.
authors: Mamoru
authors: M
authors: Arakawa
authors: Takashi
authors: T
authors: Nishimura
authors: Yoshiaki
authors: Y
authors: Takewa
authors: Akihide
authors: A
authors: Umeki
authors: Masahiko
authors: M
authors: Ando
authors: Yuichiro
authors: Y
authors: Kishimoto
authors: Yutaka
authors: Y
authors: Fujii
authors: Shunei
authors: S
authors: Kyo
authors: Hideo
authors: H
authors: Adachi
authors: Eisuke
authors: E
authors: Tatsumi
mesh_terms: D000818:Animals; D015908:Counterpulsation / Q000295:instrumentation*; D004195:Disease Models, Animal; D006041:Goats; D006353:Heart-Assist Devices / Q000009:adverse effects*; D012399:Rotation; D013599:Systole / Q000502:physiology; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D054088:Ventricular Septum / Q000000981:diagnostic imaging / Q000503:physiopathology