Journal ArticleDOI
A novel counterpulsation mode of rotary left ventricular assist devices can enhance myocardial perfusion
Masahiko Ando,Yoshiaki Takewa,Takashi Nishimura,Kenji Yamazaki,Shunei Kyo,Minoru Ono,Tomonori Tsukiya,Toshihide Mizuno,Yoshiyuki Taenaka,Eisuke Tatsumi +9 more
TLDR
In conclusion, counterpulse mode of rotary LVADs can enhance myocardial perfusion and this novel drive mode can provide great benefits to the patients with end-stage heart failure, especially those with ischemic etiology.Abstract:
The effect of rotary left ventricular assist devices (LVADs) on myocardial perfusion has yet to be clearly elucidated, and several studies have shown decreased coronary flow under rotary LVAD support. We have developed a novel pump controller that can change its rotational speed (RS) in synchronization with the native cardiac cycle. The aim of our study was to evaluate the effect of counterpulse mode, which increases the RS in diastole, during coronary perfusion. Experiments were performed on ten adult goats. The EVAHEART LVAD was installed by the left ventricular uptake and the descending aortic return. Ascending aortic flow, pump flow, and coronary flow of the left main trunk were monitored. Coronary flow was compared under four conditions: circuit-clamp, continuous mode (constant pump speed), counterpulse mode (increased pump speed in diastole), and copulse mode (increased pump speed in systole). There were no significant baseline changes between these groups. In counterpulse mode, coronary flow increased significantly compared with that in continuous mode. The waveform analysis clearly revealed that counterpulse mode mainly resulted in increased diastolic coronary flow. In conclusion, counterpulse mode of rotary LVADs can enhance myocardial perfusion. This novel drive mode can provide great benefits to the patients with end-stage heart failure, especially those with ischemic etiology.read more
Citations
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Journal ArticleDOI
Newer-generation ventricular assist devices.
Shvetank Agarwal,Kane M. High +1 more
TL;DR: The latest generation of ventricular assist devices has evolved from the pulsatile, volume-displacement pumps of the 1990s to today's non-pulsatile, constant pressure-generating rotary pumps, examining particular design features as highlighted by the designers as well as the current approval status of each device in the United States and Europe.
Journal ArticleDOI
Development of a novel drive mode to prevent aortic insufficiency during continuous-flow LVAD support by synchronizing rotational speed with heartbeat.
Yuichiro Kishimoto,Yoshiaki Takewa,Mamoru Arakawa,Akihide Umeki,Masahiko Ando,Takashi Nishimura,Yutaka Fujii,Toshihide Mizuno,Motonobu Nishimura,Eisuke Tatsumi +9 more
TL;DR: This novel drive mode may considerably benefit patients with severe heart failure on long-term LVAD support by preventing AI by providing both minimal support for early systole and maximal support shortly after aortic valve opening by changing the RS in synchronization with heartbeat.
Journal ArticleDOI
An insight into short- and long-term mechanical circulatory support systems
TL;DR: An update on currently available mechanical circulatory support systems (MCSS) for short and long-term use as well as an insight into future perspectives are offered.
Journal ArticleDOI
Alteration of LV end-diastolic volume by controlling the power of the continuous-flow LVAD, so it is synchronized with cardiac beat: development of a native heart load control system (NHLCS)
Akihide Umeki,Takashi Nishimura,Masahiko Ando,Yoshiaki Takewa,Kenji Yamazaki,Shunei Kyo,Minoru Ono,Tomonori Tsukiya,Toshihide Mizuno,Yoshiyuki Taenaka,Eisuke Tatsumi +10 more
TL;DR: It may be possible to achieve favorable EDV and native heart load by controlling the rotation of continuous-flow LVAD, so it is synchronized with the cardiac beat, according to the end-diastolic volume.
Journal ArticleDOI
Feasibility of Pump Speed Modulation for Restoring Vascular Pulsatility with Rotary Blood Pumps
Mickey S. Ising,Michael A. Sobieski,Mark S. Slaughter,Steven C. Koenig,Guruprasad A. Giridharan +4 more
TL;DR: Three candidate CF LVAD pump speed modulation algorithms designed to augment aortic pulsatility were evaluated by quantifying hemodynamic performance as a function of mean pump speed, modulation amplitude, and timing, facilitating potential clinical implementation.
References
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Journal ArticleDOI
Intraaortic Balloon Counterpulsation: A Review of Physiological Principles, Clinical Results, and Device Safety
Karl T. Weber,Joseph S. Janicki +1 more
TL;DR: This review summarizes the major aspects and current status of the IAB, which has been used in the treatment of several hundred patients with acute myocardial infarction shock and other conditions complicating the course of ischemic heart disease and characterized by low-output failure.
Journal ArticleDOI
Vertical displacement of the beating heart by the octopus tissue stabilizer: influence on coronary flow.
Paul F. Gründeman,Cornelius Borst,Joost A. van Herwaarden,Cees W.J. Verlaan,Erik W.L. Jansen +4 more
TL;DR: It is inferred that coronary blood flow was not mechanically obstructed during anterior displacement of the porcine beating heart, because augmentation of preloads by the maneuver of Trendelenburg restored coronary flow parallel to the recovery of cardiac output and mean arterial pressure while the heart remained retracted by 90 degrees.
Journal ArticleDOI
Improved regional myocardial blood flow, left ventricular unloading, and infarct salvage using an axial-flow, transvalvular left ventricular assist device. A comparison with intra-aortic balloon counterpulsation and reperfusion alone in a canine infarction model.
TL;DR: The Hemopump appears to provide superior left ventricular systolic and diastolic unloading compared with intra-aortic counterpulsation in a canine model and appears to result in significant infarct salvage compared with reperfusion alone.
Journal ArticleDOI
EVAHEART: an implantable centrifugal blood pump for long-term circulatory support.
Kenji Yamazaki,Shinichiro Kihara,Takehide Akimoto,Osamu Tagusari,Akihiko Kawai,Mitsuo Umezu,Jun Tomioka,Robert L. Kormos,Bartley P. Griffith,Hiromi Kurosawa +9 more
TL;DR: The EVAHEART centrifugal blood pump demonstrated excellent performance in long-term in-vivo experiments, and no major organ thromboembolisms occurred except for a few small renal infarcts.
Journal ArticleDOI
Physiology of continuous blood flow in recipients of rotary cardiac assist devices
TL;DR: This review summarizes the observed clinical consequences of continuous blood flow in patients supported by rotary blood pumps and relates these consequences to underlying experimental studies.