Comparison of effects of extra-thoracic paraaortic counterpulsation to intraaortic balloon pump on circulatory support in acute heart failureReportar como inadecuado

Comparison of effects of extra-thoracic paraaortic counterpulsation to intraaortic balloon pump on circulatory support in acute heart failure - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Cardiothoracic Surgery

, 10:173

First Online: 24 November 2015Received: 04 January 2015Accepted: 28 October 2015


BackgroundPreviously 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.

MethodsThe 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.

ResultsBoth 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.

ConclusionsThis 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.

KeywordsHeart failure Ventricular assist device AbbreviationsETPACDExtra-thoracic paraaortic counterpulsation device

IABPIntraaortic balloon pump

CHFCongestive heart failure

PACDParaaortic counterpulsation device

HRHeart rate

SAPSystolic aortic pressure

MADPMean aortic diastolic pressure

CVPCentral venous pressure

COCardiac output


LCAFLeft carotid artery flow

ACTActivated coagulation time

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Autor: Jie-Min Zhang - Xiao-Cheng Liu - Zhi-Gang Liu - Long Zhao - Li Yang - Tian-Wen Liu - Guo-Wei He


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