Right ventricular support for off-pump coronary artery bypass grafting studied with bi-ventricular pressure–volume loops in sheep

Abstract

Restricted right ventricular filling is the primary cause of the strong decrease in cardiac output during tilting. The Enabler right ventricular support can currently not restore cardiac output to pre-tilting values, mainly caused by its limited output and a decrease in right ventricular output upon Enabler activation. Constant monitoring of cardiac output is crucial during (unsupported or supported) tilting as blood pressure alone may not reflect the extent of the reduction in cardiac function.

Initial Experience with a New Right Ventricular Support Device for Beating Heart Surgery

“…Experimental echocardiographic findings identify restricted RV filling as the major cause of hemodynamic depression during exposure of the left circumflex branches (6). Right ventricular support during cardiac tilting for off‐pump surgery may counteract this mechanism and provide stable hemodynamics during adequate cardiac exposure (5).…”

“…Although sophisticated devices have been developed for the careful exposure of the LV posterior and lateral wall during off‐pump surgery, hemodynamic instability during cardiac luxation remains a significant concern in particular in patients with compromised LV function. One major cause for hemodynamic instability during cardiac luxation seems to be restriction of right ventricular (RV) filling caused by bending of the caval veins which may be compensated by mechanical RV support (5,6). Recently, newly designed microaxial flow pumps (Impella, Impella Cardiotechnik AG, Aachen, Germany) have been introduced for left and RV support during beating heart CABG surgery (7).…”

Implantable RF telemetry for cardiac monitoring in the murine heart: a tutorial review

“…That is, a larger heart volume would allow for multiple pairs of ring electrodes and, therefore, it would be electrically divided into several smaller volume segments stacked on top of each other. In the case of larger animal subjects, it is not only possible to use a catheter with more than one inner pair of electrodes, but also it is possible to implant two catheters-one in each ventricle [30]. If the two-catheter measurement is to be used in a mouse heart then, in order to be able to fit inside of the RV, a new significantly smaller PV catheter must be developed first (Figure 3).…”

The First Use of the Impella Microaxial VAD®Ventricular Assist Device in Our Country for Coronary Artery Bypass Surgery in the Beating Heart: Case Report

“…15,18 Hay van de ne yi ça-lış ma la rın da, eko kar di yog ra fik bul gu ola rak, atan kalp te bay pas uy gu la ma sı sırasında ve özel lik le Cx ko ro ner ar ter dal la rı na ya pı lan anas to moz iş le mi sı-ra sın da sol ven tri kül do lu şu nun ve bo şal ma sı nın kı sıt lan dı ğı, so nuç ta he mo di na mik ins ta bi li te ye sebe bi yet ver ildi ği gö rül müş tür. 5 Atan kalp te bay pas ame li ya tı sı ra sın da, des tek ci ha zı ola rak sen tri fu gal pom pa lar ve ya mik ro ak si yal akım lı pom pa lar se çi -le bi lir. Bu iki ci haz kar şı laş tı rıl dı ğın da, ye ni ne sil mik ro ak si yal min ya tür pom pa la r, kul la nım ko laylı ğı, ol duk ça kü çük ol ma la rı, yük sek akım hı zı na (0 -30.000 rpm) he mo li ze yol aç ma dan izin ver me leri, ya ban cı yü zey ala nın kü çük ol ma sı ve akım ayarın da bir çok op si yo na sa hip olmaları nedeniyle yük sek ça lış ma akı mı na ih ti yaç duy ma maları gi bi özel lik le ri ile, di ğe ri ne gö re da ha üs tün dür (Re sim 3).…”

“…He mo di na mik ins ta bi li te, özel lik le çok da mar lezyon la rın da pos te ri or ve la te ral sol ven tri kül du var fonk si yon la rı için çok önem li olan anas to mo zun ka li te si ni, ne ga tif ola rak et ki ler. 5,6 Off-pump ko roner ar ter bay pas (OP CAB) ame li yat tek ni ği va sı tasıy la mor ta li te ve mor bi di te nin azal dı ğı nı gös te ren bir çok ye ni ra por var dır. 7 Bu ra por da, ül ke miz de ilk kez yük sek risk li (EU ROS CO RE ® ) iki has ta da atan kalp te ko ro ner baypass ame li ya tı sı ra sın da des tek alı nan, cer ra hi ka li te yi ve kon fo ru art tı rarak mi yo kar di yal ko ru ma sağ la yan Im pel la Mic roa xi al VADs ® (Ven tri cu lar As sist De vi ce System) uy gu la ma sı an la tıl mış tır.…”