Comparison of effects of extra-thoracic paraaortic counterpulsation to intraaortic balloon pump on circulatory support i
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RESEARCH ARTICLE
Open Access
Comparison of effects of extra-thoracic paraaortic counterpulsation to intraaortic balloon pump on circulatory support in acute heart failure Jie-Min Zhang1, Xiao-Cheng Liu1*, Zhi-Gang Liu1, Long Zhao1, Li Yang1, Tian-Wen Liu1 and Guo-Wei He1,2*
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. Keywords: Heart failure, Ventricular assist device
Background The incidence of congestive heart failure (CHF) is increasing worldwide, with more than one million new cases diagnosed annually. Current treatment options for CHF include optimal medical management therapy, mechanical ventricular assist, and heart transplantation. * Correspondence: [email protected]; [email protected] 1 Center for Circulatory Support and Animal Lab., & Center for Basic Medical Research, TEDA International Cardiovascular Hospital, No.61, the 3rd, TEDA, Tianjin 300457, China Full list of author information is available at the end of the article
Over the past four decades, the intra-aortic balloon pump (IABP) is the most widely used short-term cardiac assist device with over 160,000 balloons implanted each year worldwide with up to 65 % successful clinical outcomes [1–3]. Despite notable advantages, includ
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