Extra-Ascending Aortic Versus Intra-Descending Aortic Balloon Counterpulsation—Effect on Coronary Artery Blood Flow

Davies, Ann D. M.; Peters, Wolfgang; Su, Tonglin; Sullivan, Colin E.; Perkidides, Theo; Milsom, F. Paget; White, Geoffrey H.

doi:10.1016/j.hlc.2005.03.018

Cited by 22 publications

(22 citation statements)

References 28 publications

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“…It also increases peak diastolic flow velocity by 117% and coronary flow velocity integral by 87% as shown by previous ECG and color Doppler studies [6•]. EAB counterpulsation devices have been shown to be similar to known hemodynamic effects of IABP devices [11]. In vivo studies of Davies et al [11] compared the hemodynamic effect of the existing IABP technique with the newly developed EAB device in an acute pig model.…”

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 74%

“…3A, point 3). More importantly, coronary blood flow studies by Davies et al [11] reported that EAB was more efficient in improving diastolic coronary blood flow over baseline by 69% (P< 0.05) compared with IABP during counterpulsation with 1:1 augmentation mode. The diastolic blood coronary flow in the 1:2 mode was also increased significantly by EAB (63%, assisted vs unassisted beat, P<0.05) compared with IABP (28%, P<0.01; Fig.…”

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 96%

“…Results from Davies et al [11] have demonstrated that diastolic counterpulsation in the C-pulse devices is more efficient at the level of the ascending aorta than at the descending aorta. More effective diastolic counterpulsation is caused by several factors: 1) the closer the diastolic pulse wave production is to the aortic valve, the more synchronized is the counterpulsation to the cardiac cycle; 2) pulse diffusion is minimized, thus maximizing counterpulsation efficiency; and 3) blood volume displacement from the ascending aorta during end-diastole is increased, resulting in more pronounced and larger central aortic end -diastolic pressure fall.…”

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 99%

“…EAB counterpulsation devices have been shown to be similar to known hemodynamic effects of IABP devices [11]. In vivo studies of Davies et al [11] compared the hemodynamic effect of the existing IABP technique with the newly developed EAB device in an acute pig model. Davies et al [11] compared the effects of EAB with a balloon volume of 17 mL secured around the ascending aorta to a standard IABP with a balloon volume of 25 mL positioned in the descending aorta.…”

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 99%

“…Both counterpulsation devices exhibited increased diastolic and systolic coronary blood The predominant hemodynamic effects of the EAB pump are aortic blood flow augmentation during inflation phase with increased coronary blood flow (ventricular diastole) and ventricular unloading during the deflation phase (immediately before ventricular systole). Pre-systolic unloading contributes to improvement of cardiac output and myocardial contractility as a consequence of reduced endsystolic wall stress, left ventricular pressure and volume, and myocardial oxygen consumption [11,12]. Both of these devices substantially increase pre-systolic unloading.…”

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 99%

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Understanding the C-Pulse Device and Its Potential to Treat Heart Failure

Sales

McCarthy

2010

Curr Heart Fail Rep

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The Sunshine Heart C-Pulse (C-Pulse; Sunshine Heart Inc., Tustin, CA) device is an extra-aortic implantable counterpulsation pump designed as a non-blood contacting ambulatory heart assist device, which may provide relief from symptoms for class II-III congestive heart failure patients. It has a comparable hemodynamic augmentation to intra-aortic balloon counterpulsation devices. The C-Pulse cuff is implanted through a median sternotomy, secured around the ascending aorta, and pneumatically driven by an external system controller. Pre-clinical studies in the acute pig model, and initial temporary clinical studies in patients undergoing off-pump coronary bypass surgery have shown substantial increase in diastolic perfusion of the coronary vessels, which translated to a favorable improvement in ventricular function. A U.S. prospective multi-center trial to evaluate the safety and efficacy of the C-Pulse in class III patients with moderate heart failure is now in progress.

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Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 74%

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 96%

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 99%

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 99%

Section: Initial Temporary Pre-clinical Hemodynamic Studies On C-pulsmentioning

confidence: 99%

See 3 more Smart Citations

Understanding the C-Pulse Device and Its Potential to Treat Heart Failure

Sales

McCarthy

2010

Curr Heart Fail Rep

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Feasibility of a Dielectric Elastomer Augmented Aorta

et al. 2021

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Although heart transplantation is a gold standard for severe heart failure, there is a need for alternative effective therapies. A dielectric‐elastomer aorta is used to augment the physiological role of the aorta in the human circulatory system. To this end, the authors developed a tubular dielectric elastomer actuator (DEA) able to assist the heart by easing the deformation of the aorta in the systole and by increasing its recoil force in the diastole. In vitro experiments using a pulsatile flow‐loop, replicating human physiological flow and pressure conditions, show a reduction of 5.5% (47 mJ per cycle) of the heart energy with this device. Here, the controlled stiffness of the DEA graft, which is usually difficult to exploit for actuators, is perfectly matching the assistance principle. At the same time, the physiological aortic pressure is exploited to offer a prestretch to the DEA which otherwise would require an additional bulky pre‐stretching system to reach high performances.

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A novel soft cardiac assist device based on a dielectric elastomer augmented aorta: An in vivo study

Martinez

Jahren

Walter

et al. 2022

Bioengineering & Transla Med

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Although heart transplant is the preferred solution for patients suffering from heart failures, cardiac assist devices remain key substitute therapies. Among them, aortic augmentation using dielectric elastomer actuators (DEAs) might be an alternative technological application for the future. The electrically driven actuator does not require bulky pneumatic elements (such as conventional intra-aortic balloon pumps) and conforms tightly to the aorta thanks to the manufacturing method presented here. In this study, the proposed DEA-based device replaces a section of the aorta and acts as a counterpulsation device. The feasibility and validation of in vivo implantation of the device into the descending aorta in a porcine model, and the level of support provided to the heart are investigated. Additionally, the influence of the activation profile and delay compared to the start of systole is studied. We demonstrate that an activation of the DEA just before the start of systole (30 ms at 100 bpm) and deactivation just after the start of diastole (0-30 ms) leads to an optimal assistance of the heart with a maximum energy provided by the DEA. The end-diastolic and left ventricular pressures were lowered by up to 5% and 1%, respectively, compared to baseline. The early diastolic pressure was augmented in average by up to 2%.

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Extra-Ascending Aortic Versus Intra-Descending Aortic Balloon Counterpulsation—Effect on Coronary Artery Blood Flow

Cited by 22 publications

References 28 publications

Understanding the C-Pulse Device and Its Potential to Treat Heart Failure

Understanding the C-Pulse Device and Its Potential to Treat Heart Failure

Feasibility of a Dielectric Elastomer Augmented Aorta

A novel soft cardiac assist device based on a dielectric elastomer augmented aorta: An in vivo study

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