Impact of an Accessory for Left Ventricular Assist Devices on Device Flow and Pressure Head In Vitro

Meissner, Florian; Eichelkraut, Derya; Schimmel, Marius; Maier, Sven; Vestner, Heiko; Schoen, Manuela; Czerny, Martin; Bothe, Wolfgang

doi:10.3390/bioengineering10040486

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…We develop an LVAD accessory redirecting the blood through a transventricular OG across the aortic valve (AV) (Fig. 1 B) [ 3 ]. Applying the LVAD accessory allows less invasive LVAD implantation via a single transapical approach [ 4 ].…”

Section: Case Presentationmentioning

confidence: 99%

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Intra-aortic band impairs transapical device implantation in a pig: a case report

Meissner,

Costa Galbas,

Dinkelaker

et al. 2023

BMC Vet Res

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Background Anatomic anomalies in the ascending aorta may impair the implantation and testing of cardiovascular devices in humans and animal models. Case presentation We present the rare case of an intra-aortic band in a German Landrace pig. During terminal animal testing, the band hindered the implantation of a left ventricular assist device (LVAD) with transventricular outflow graft across the aortic valve. After lower partial sternotomy, epicardial echocardiography displayed an intraluminal echogenic structure at the sinotubular junction causing unspecific flow turbulences. Under cardiopulmonary bypass, coring of the left ventricular apex was performed. Due to strong resistance in the proximal aorta, accurate positioning of the transventricular LVAD outflow graft was impossible. After euthanasia, necropsy revealed a fibrous band located at the sinotubular junction, dividing the lumen of the ascending aorta. Conclusions The occurrence of an intra-aortic band represents an extremely rare case of a most likely congenital anomaly. Awareness of such anomalies is important for planning and performing animal testing. Perioperative echocardiography may help to either remove such anomalies or allow discontinuing the procedure prior to device implantation.

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Section: Case Presentationmentioning

confidence: 99%

“…1 Left ventricular assist device (LVAD) with (A) conventional outflow graft as well as (B) LVAD accessory with transventricular outflow graft (figures representing human anatomy). Adapted from Meissner et al [ 3 ] …”

Section: Case Presentationmentioning

confidence: 99%

Intra-aortic band impairs transapical device implantation in a pig: a case report

Meissner,

Costa Galbas,

Dinkelaker

et al. 2023

BMC Vet Res

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“…Referring to our research fields, mechanical circulatory support devices and coronary interventions, we are interested in specific cardioaortic dimensions. Among others, we develop an LVAD accessory redirecting the blood from the pump through a transventricular outflow graft across the aortic valve (AV) into the ascending aorta (AAo) 3 , 11 . In contrast, conventional devices direct the blood through an extraventricular outflow graft anastomosed to the AAo.…”

Section: Introductionmentioning

confidence: 99%

Cardioaortic dimensions in German landrace pigs derived from cardiac magnetic resonance imaging

Meissner,

Galbas,

Szvetics

et al. 2024

Sci Rep

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Pigs are frequently applied as animal models in cardiovascular research due to their anatomical and physiological similarity to humans. For study planning and refinement, precise knowledge of the cardioaortic dimensions is essential. In a retrospective single-center study, the cardioaortic dimensions and left ventricular function of German Landrace pigs were assessed using cardiac MRI. All parameters were compared between male and female pigs and analyzed for correlation with body weight. In total, 15 pigs were included (7 male and 8 female, weight 60.9 ± 7.0 kg). The left ventricle revealed an end-diastolic diameter of 50.5 ± 4.4 mm and an ejection fraction of 51.2 ± 9.8%. The diameters of the ascending and descending aorta were 21.3 ± 2.3 and 16.2 ± 1.4 mm, respectively. There were no significant differences between male and female pigs, except that males had a smaller end-diastolic left ventricular volume (p = 0.041). A moderate correlation was found between body weight and the aortic annulus diameter (R = 0.57, p = 0.027). In conclusion, cardiac MRI allows precise quantification of porcine cardioaortic dimensions. For medical device testing, size differences between pigs and humans should be considered.

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Longitudinal cardiac dimensions in patients undergoing LVAD implantation

Meissner,

Szvetics,

Galbas

et al. 2024

Artificial Organs

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BackgroundIn conventional left ventricular assist devices (LVAD), a separate outflow graft is sutured to the ascending aorta. Novel device designs may include a transventricular outflow cannula crossing the aortic valve (AV). While transversal ventricular dimensions are well investigated in patients with severe heart failure, little is known about the longitudinal dimensions. These dimensions are, however, particularly critical for the design and development of mechanical circulatory support (MCS) devices with transaortic outflow cannula.MethodsIn an explorative retrospective cohort study at the University Medical Center Freiburg, Germany, the longitudinal cardiac dimensions of patients undergoing computed tomography angiography (CTA) before and, if available, after LVAD implantation were analyzed. Among others, the following dimensions were assessed: (a) apex to AV, (b) apex to mitral valve, (c) AV to sinotubular junction (STJ), (d) apex to STJ, (e) apex to brachiocephalic artery (BCA), and (f) AV to BCA.ResultsIn total, 44 LVAD patients (36 male, age 55.8 years, height 1.75 m) were included. The longitudinal cardiac dimensions were (a) 114.5 ± 12.1 mm, (b) 108.0 ± 12.4 mm, (c) 20.9 ± 2.9, (d) 135.4 ± 13.4 mm, (e) 206.0 ± 18.3, and (f) 91.5 ± 9.8 mm. Postoperatively, (a) and (b) decreased by 31.5% and 39.5%, respectively (N = 14).ConclusionsLongitudinal cardiac dimensions may be reduced by up to 40% after LVAD implantation. A better knowledge of these dimensions and their postoperative alterations in LVAD patients may improve surgical planning and help to design MCS devices with transventricular outflow cannula.

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Impact of an Accessory for Left Ventricular Assist Devices on Device Flow and Pressure Head In Vitro

Cited by 4 publications

References 13 publications

Intra-aortic band impairs transapical device implantation in a pig: a case report

Intra-aortic band impairs transapical device implantation in a pig: a case report

Cardioaortic dimensions in German landrace pigs derived from cardiac magnetic resonance imaging

Longitudinal cardiac dimensions in patients undergoing LVAD implantation

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