title: Hemodynamic effects of left atrial or left ventricular cannulation for acute circulatory support in a bovine model of left heart injury.
abstract: Our objective was to examine the hemodynamic effects of a trans-aortic axial flow catheter (Impella CP) in the left ventricle (LV) versus left atrial (LA) to femoral artery bypass using a centrifugal pump (TandemHeart: TH) in a bovine model of acute LV injury. In three male calves, we performed sequential activation of a CP then TH device in each animal. After 60 minutes of left anterior descending artery ligation, a CP was activated at maximal power. The CP was then removed and the TH activated at 5,500 then a maximum of 7,500 rotations per minute (RPM). The CP generated a maximum 3.1 ± 0.2 L/minute (LPM) of flow, whereas the TH at 5,500 and 7,500 RPM generated 3.1 ± 0.4 and 4.4 ± 0.3 LPM. At 3.1 LPM, the CP and TH reduced LV stroke work (LVSW) similarly. The TH reduced stroke volume, whereas the CP did not. The CP reduced end-systolic pressure, whereas the TH did not. At a maximum flow of 4.4 LPM, the TH provided a greater reduction in LVSW than maximal CP activation. This is the first report to compare the hemodynamic effects of trans-aortic LV unloading versus LA-to-femoral artery (FA) bypass.
authors.affiliation: From The Molecular Cardiology Research Institute and Surgical/Interventional Research Laboratories, Tufts Medical Center and Tufts University School of Medicine, 800 Washington Street, Boston, MA 02339.
authors.forename: Navin K
authors.initials: NK
authors.lastname: Kapur
authors.forename: Vikram
authors.initials: V
authors.lastname: Paruchuri
authors.forename: Duc Thinh
authors.initials: DT
authors.lastname: Pham
authors.forename: Lara
authors.initials: L
authors.lastname: Reyelt
authors.forename: Barbara
authors.initials: B
authors.lastname: Murphy
authors.forename: Corinna
authors.initials: C
authors.lastname: Beale
authors.forename: Courtney
authors.initials: C
authors.lastname: Bogins
authors.forename: Daniel
authors.initials: D
authors.lastname: Wiener
authors.forename: James
authors.initials: J
authors.lastname: Nilson
authors.forename: Michele
authors.initials: M
authors.lastname: Esposito
authors.forename: Scott
authors.initials: S
authors.lastname: Perkins
authors.forename: George
authors.initials: G
authors.lastname: Perides
authors.forename: Richard H
authors.initials: RH
authors.lastname: Karas
mesh_terms: D000818:Animals; D002417:Cattle; D004195:Disease Models, Animal; D006352:Heart Ventricles / Q000503:physiopathology*; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology*; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*