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A Novel Subcutaneous Counterpulsation Device: Acute Hemodynamic Efficacy During Pharmacologically Induced Hypertension, Hypotension, and Heart Failure
Author(s) -
Bartoli Carlo R.,
Wilson Gregory C.,
Giridharan Guruprasad A.,
Slaughter Mark S.,
Sherwood Leslie C.,
Spence Paul A.,
Prabhu Sumanth D.,
Koenig Steven C.
Publication year - 2010
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.2010.01009.x
Subject(s) - medicine , heart failure , cardiology , hemodynamics , cardiac output , stroke volume , artery , anesthesia , ejection fraction
The miniaturization of mechanical assist devices and less invasive implantation techniques may lead to earlier intervention in patients with heart failure. As such, we evaluated the effectiveness of a novel, minimally invasive, implantable counterpulsation device (CPD) in augmenting cardiac function during impaired hemodynamics. We compared the efficacy of a 32‐mL stroke volume CPD with a standard 40‐mL intra‐aortic balloon pump (IABP) over a range of clinically relevant pathophysiological conditions. Male calves were instrumented via thoracotomy, the CPD was anastomosed to the left carotid artery, and the IABP was positioned in the descending aorta. Hemodynamic conditions of hypertension, hypotension, and heart failure were pharmacologically simulated and data were recorded during CPD and IABP support (off, 1:2, 1:1 modes) for each condition. In all three pathophysiological conditions, the CPD and IABP produced similar and statistically significant ( P < 0.05) increases in coronary artery blood flow normalized to the left ventricular (LV) workload. During hypotension and heart failure conditions, however, the CPD produced significantly greater reductions in LV workload and myocardial oxygen consumption as compared with the IABP. A novel 32‐mL CPD connected to a peripheral artery produced equivalent or greater hemodynamic benefits than a standard 40‐mL IABP during pharmacologically induced hypertension, hypotension, and heart failure conditions.