title: Comparison of effects of extra-thoracic paraaortic counterpulsation to intraaortic balloon pump on circulatory support in acute heart failure.
abstract: BACKGROUND
  Previously designed intra-thoracic paraaortic counterpulsation device has limited stroke volume and may depress the lung to cause complications. The purpose of this study was to evaluate the hemodynamic effects of an extra-thoracic paraaortic counterpulsation device (ETPACD) in comparison to intraaortic balloon pump (IABP) in an animal model with acute heart failure.
  
  
  METHODS
  The acute heart failure model was successfully induced by snaring branch of anterior descending coronary artery in sheep (weighting, 38-50 kg, n = 8). The ETPACD is a single port, 65-ml stroke volume blood chamber designed to be connected to descending aorta through a valveless graft and placed extra-thorax. In comparison, a standard clinical 40-ml IABP was placed in the descending aorta. The hemodynamic indices of both devices were recorded during counterpulsation assistance. Two of the sheep were allowed to survive for 1 week to examine the prolonged effect.
  
  
  RESULTS
  Both ETPACD and IABP increased cardiac output with higher effect of ETPACD (13.52 % vs. 8.19 % in IABP, P < 0.05) and on mean diastolic aortic pressure (26.73 % vs. 12.58 % in IABP, P < 0.01). Both ETPACD and IABP also produced a greater reduction in left ventricular end-diastolic pressure (26.77 % vs. 23.08 %, P > 0.05). The ETPACD increased left carotid artery flow more significantly the IABP (18.00 % vs. 9.19 % , P < 0.05). In two of the sheep allowed to survive for 1 week, the device worked well with no complications and there was no thrombus formation in the chamber of ETPACD.
  
  
  CONCLUSIONS
  This study demonstrated that both ETPACD and IABP provided benefit of circulatory support in acute heart failure with better effect on hemodynamic parameters provided by ETPACD. Therefore, ETPACD with theoretical larger stroke volume may become a promising counterpulsation device for treatment of heart failure.
authors.affiliation: Center for Circulatory Support and Animal Lab., & Center for Basic Medical Research, TEDA International Cardiovascular Hospital, No.61, the 3rd, TEDA, Tianjin, 300457, China. zzjjmm126@126.com.
authors.forename: Jie-Min
authors.initials: JM
authors.lastname: Zhang
authors.affiliation: Center for Circulatory Support and Animal Lab., & Center for Basic Medical Research, TEDA International Cardiovascular Hospital, No.61, the 3rd, TEDA, Tianjin, 300457, China. liuxc@tedaich.com.
authors.forename: Xiao-Cheng
authors.initials: XC
authors.lastname: Liu
authors.affiliation: Center for Circulatory Support and Animal Lab., & Center for Basic Medical Research, TEDA International Cardiovascular Hospital, No.61, the 3rd, TEDA, Tianjin, 300457, China. liuzg@tedaich.com.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Liu
authors.affiliation: Center for Circulatory Support and Animal Lab., & Center for Basic Medical Research, TEDA International Cardiovascular Hospital, No.61, the 3rd, TEDA, Tianjin, 300457, China. wjemma@126.com.
authors.forename: Long
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Center for Circulatory Support and Animal Lab., & Center for Basic Medical Research, TEDA International Cardiovascular Hospital, No.61, the 3rd, TEDA, Tianjin, 300457, China. w.j.emma@hotmail.com.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Center for Circulatory Support and Animal Lab., & Center for Basic Medical Research, TEDA International Cardiovascular Hospital, No.61, the 3rd, TEDA, Tianjin, 300457, China. wangjun@tedaich.com.
authors.forename: Tian-Wen
authors.initials: TW
authors.lastname: Liu
authors.affiliation: Center for Circulatory Support and Animal Lab., & Center for Basic Medical Research, TEDA International Cardiovascular Hospital, No.61, the 3rd, TEDA, Tianjin, 300457, China. heguowei@nankai.edu.cn.|Department of Surgery, Oregon Health and Science University, Portland, OR, USA. heguowei@nankai.edu.cn.
authors.forename: Guo-Wei
authors.initials: GW
authors.lastname: He
mesh_terms: D000208:Acute Disease; D000818:Animals; D002302:Cardiac Output; D015908:Counterpulsation / Q000379:methods; D004195:Disease Models, Animal; D004867:Equipment Design; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D012756:Sheep; D035441:Thoracic Wall