Open AccessIndividualized Biventricular Epicardial Augmentation Technology in a Drug-Induced Porcine Failing Heart Model
Author(s) -
Lasse Jagschies,
Marc Hirschvogel,
José Matallo,
Andreas Maier,
Karin Mild,
Horst Brünner,
Rabea Hinkel,
Michael W. Gee,
Peter Radermacher,
Stephen M. Wildhirt,
Sebastian Häfner
Publication year - 2018
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.961
H-Index - 66
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000000686
Subject(s) - medicine , isovolumetric contraction , cardiology , heart failure , implant , heart transplantation , cardiac function curve , cardiac resynchronization therapy , diastole , stroke volume , ventricular assist device , biomedical engineering , surgery , blood pressure , ejection fraction
For treatment of advanced heart failure, current strategies include cardiac transplantation or blood-contacting pump technology associated with complications, including stroke and bleeding. This study investigated an individualized biventricular epicardial augmentation technology in a drug-induced porcine failing heart model. A total of 11 pigs were used, for the assessment of hemodynamics and cardiac function under various conditions of support pressures and support durations (n = 4), to assess device positioning and function by in vivo computer tomographic imaging (n = 3) and to investigate a minimally invasive implantation on the beating heart (n = 4). Support pressures of 20-80 mm Hg gradually augmented cardiac function parameters in this animal model as indicated by increased left ventricular stroke volume, end-systolic pressures, and decreased end-diastolic pressures. Strong evidence was found regarding the necessity of mechanical synchronization of support end with the isovolumetric relaxation phase of the heart. In addition, the customized, self-expandable implant enabled a marker-guided minimally invasive implantation through a 4 cm skin incision using fluoroscopy. Correct positioning was confirmed in computer tomographic images. Continued long-term survival investigations will deliver preclinical evidence for further development of this concept.