Skeletal muscle ventricle aortic counterpulsation: function during chronic heart failure

Patel, Bhavik G; Shah, Sachin H.; Astra, Lou I; Hammond, Robert L.; Sharif, Zulfikar A; McDonald, Philip; Stephenson, Larry W.

doi:10.1016/s0003-4975(01)03458-0

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…The SMV model with the longest chronic data (3) utilizes an IsoVol conditioning phase followed by direct connection to the circulation (3,5,9–11). The wall stress in these SMVs at 75 mm Hg (11), at the SMV base (radius 1.5 cm), using 2.5 muscle wraps (1.0–1.2 cm thick wall) would be approximately 1.25–1.5 N/cm 2 .…”

Section: Discussionmentioning

confidence: 99%

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Is Skeletal Muscle Ventricle Chronic Stability Dependent on Wall Stress? Design Implications

et al. 2005

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Chronic skeletal muscle ventricle (SMV) stability is essential for clinical implementation. SMVs in animal models have chronically expanded or collapsed when exposed to physiologic pressures. SMV wall stress is a more appropriate indicator than pressure or geometry to compare SMVs between studies. SMV wall tensions during conditioning were determined for SMVs that collapsed, expanded, or were isovolumetric in a previous study. Wall stresses in SMVs that expanded (2.76 +/- 0.803 N/cm(2)) were significantly greater than isovolumetric SMVs (0.89 +/- 0.450) and SMVs that collapsed (0.88 +/- 0.451). These data support the existence of minimum and maximum wall stresses for SMV volume stability and provide empiric estimates for SMV design. Scaling SMV designs from animal models with smaller volumes and similar pressures may result in greater wall stresses in clinical designs. Therefore, the use of volume limiting implants or an isovolumetric conditioning phase to increase the wall stress expansion threshold may be required.

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Section: Discussionmentioning

confidence: 99%

“…The use of skeletal muscle ventricles (SMVs) to provide cardiac assistance has been investigated in a number of animal models (1)(2)(3)(4)(5)(6)(7). SMVs connected to the circulation may be directly exposed to physiologic pressures.…”

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confidence: 99%

Is Skeletal Muscle Ventricle Chronic Stability Dependent on Wall Stress? Design Implications

et al. 2005

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“…23 Both the SMV and the IABP continued to provide appreciable augmentation of diastolic pressure and EVR in the compromised system. Although it has been shown previously that SMV assist can increase coronary blood flow in chronic heart failure, 23 we have demonstrated in the present study that the IABP and SMV both significantly increased the blood flow in vessels with distal obstruction to flow. Therefore, the SMV has the potential to augment coronary artery blood flow to ischemic myocardium even when its own blood supply is potentially compromised in a low-output syndrome.…”

Section: Acute Heart Failure Modelmentioning

confidence: 96%

Counterpulsation From the Skeletal Muscle Ventricle and the Intraaortic Balloon Pump in the Normal and Failing Circulations

et al. 2006

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Background-The intra-aortic balloon pump (IABP) is the device that is in most common use to provide cardiovascular support. A skeletal muscle ventricle (SMV) was configured to produce counterpulsation in the thoracic aorta similar to that obtained with an IABP. The hemodynamic effects of an IABP and a SMV in the same animal and in both normal and failing circulations were assessed. Methods and Results-SMVs were connected to and IABPs were placed in the thoracic aorta of 12 anesthetized pigs.Hemodynamic parameters during the IABP-or the SMV-assisted beat were compared with those during the preassist beat. Acute heart failure was induced in 6 of the pigs by snaring the left anterior descending coronary artery (LAD). The hemodynamic effects of the IABP and the SMV were then reassessed. In the assisted cycles, SMV activation increased the mean aortic diastolic pressure (MADP) by 26.5Ϯ3.5%, the mean diastolic LAD flow by 48.4Ϯ7.2%, and endocardial viability ratio (EVR) by 31.6Ϯ3.8% (PϽ0.0001). In the same animals, IABP assist increased MADP by 19.8Ϯ2.3%, mean diastolic LAD flow by 37.2Ϯ3.9%, and EVR by 21.4Ϯ3.0% (PϽ0.0001). Under acute heart failure conditions, both SMV and IABP assist significantly increased MADP, mean diastolic LAD flow, and EVR. Conclusions-In both the normal and failing circulations, the SMV was an effective counterpulsator, providing cardiac assist that was at least equal to that available from an IABP. The SMV may therefore provide the proven benefits of an IABP in ambulant patients.

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“…Multiple surgical approaches (aortomyoplasty 80 , skeletal muscle ventricle 81 ), and invasive devices (Paraaortic Counterpulsation Device 82 , CardioVAD 17 ) aimed to supplement cardiac function for long-term therapy. However, these approaches all required sternotomy or thoracotomy.…”

Section: Partial-support Devices: Counterpulsation Devicesmentioning

confidence: 99%

The Future of Adult Cardiac Assist Devices: Novel Systems and Mechanical Circulatory Support Strategies

Bartoli

Dowling

2011

Cardiology Clinics

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Synopsis The recent, widespread success of mechanical circulatory support has ushered in a new era of cardiovascular medicine in which numerous implantable devices exist to treat advanced heart failure. As cardiac assist devices gain prevalence in the clinical management of cardiovascular disease, it is increasingly important to raise awareness of novel device systems, the unique mechanisms by which they function, and implications for patient management. In this article, we present state-of-the-art devices that are currently under development or in clinical trials. Devices are categorized as Standard Full-Support (HeartMate III, CorAide, Evaheart LVAS), Less-Invasive Full-Support (MVAD), Partial-Support (CircuLite Synergy Pocket Micro-Pump, Reitan Catheter Pump, Procyrion CAD, C-Pulse, Symphony Counterpulsation Device) Right Ventricular Assist Device (RVAD; DexAide, Impella RD Recover, Impella RP), and Total Artificial Heart (TAH; CardioWest, AbioCor II, Continuous-Flow TAH, Continuous-Flow BiVAD). Implantation strategy, mechanism of action, durability, efficacy, hemocompatibility, and human factors such as quality of life during device support are considered. The feasibility of novel strategies for unloading the failing heart is examined.

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Skeletal muscle ventricle aortic counterpulsation: function during chronic heart failure

Cited by 8 publications

References 13 publications

Is Skeletal Muscle Ventricle Chronic Stability Dependent on Wall Stress? Design Implications

Is Skeletal Muscle Ventricle Chronic Stability Dependent on Wall Stress? Design Implications

Counterpulsation From the Skeletal Muscle Ventricle and the Intraaortic Balloon Pump in the Normal and Failing Circulations

The Future of Adult Cardiac Assist Devices: Novel Systems and Mechanical Circulatory Support Strategies

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