title: New evidence for favourable effects on haemodynamics and ventricular performance after Parachute(®) implantation in humans.
abstract: OBJECTIVE
  The Parachute(®) Ventricular Partitioning Device offers an additional strategy for heart failure patients with exclusion of the infarcted wall to decrease left ventricular volumes, myocardial work, and wall stress. The aim of the present study was to evaluate if Parachute implantation might influence acute haemodynamic and functional performance in patients with left ventricular aneurysm after anteroapical infarction.
  
  
  RESULTS
  Sixteen patients underwent a Parachute device implantation. Invasive right and left heart haemodynamic assessments as well as left ventricular analysis for evaluating left ventricle end-diastolic and end-systolic volumes, and regional ventricular function were analysed. After implantation a significant increase in stroke volume (+25.4%, P = 0.0005), stroke volume index (+26.5%, P = 0.0005), cardiac output (+25.8%, P < 0.0001) and cardiac index (+25.9%, P < 0.0001) was found. In addition to an increase in mean aortic (P = 0.0050) and pulmonary pressure (P = 0.0347), there were significant increases in stroke work index (P = 0.0003), left (P = 0.0015) and right (P = 0.0024) ventricular stroke work index as well as left and right cardiac work index (both P = 0.0001), while the remaining haemodynamic parameters remained unchanged. Left ventricular analysis showed an acute reduction of the left ventricular end-diastolic volume (-18.0%, P < 0.0001) and left ventricular end-systolic volume (-26.3%, P < 0.0001) and an increase in ejection fraction from 22.9 to 30.6% (+38.4%, P < 0.0001). Most interestingly, the basal wall segments displayed an increased contribution to the left ventricular ejection fraction with increased wall motion in nearly all segments (except the apex region).
  
  
  CONCLUSIONS
  The data demonstrate the acute haemodynamic efficacy of Parachute device implantation. The implantation of the device displays immediate significant left ventricular volume reduction leading to an acute improved right and left cardiac function, proving the concept of left ventricular partitioning.
authors.affiliation: ASKLEPIOS Klinik St. Georg Hospital, Division of Cardiology, Lohmühlenstrasse 5, 20099, Hamburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schmidt
authors.forename: Christian
authors.initials: C
authors.lastname: Frerker
authors.forename: Thomas
authors.initials: T
authors.lastname: Thielsen
authors.forename: Inge
authors.initials: I
authors.lastname: Dotz
authors.forename: Peter
authors.initials: P
authors.lastname: Wohlmuth
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schäfer
mesh_terms: D000368:Aged; D002302:Cardiac Output; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects / Q000379:methods; D058409:Cardiac Resynchronization Therapy Devices; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000150:complications*; D009929:Organ Size; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology
keywords: aneurysm; device therapy; haemodynamics; heart failure