Is Continuous Flow Superior to Pulsatile Flow in Single Ventricle Mechanical Support? Results from a Large Animal Pilot Study

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Yasuhiro FujiiOlaf Reinhartz

Abstract

Durable mechanical support in situations of physiologic single ventricle has been met with little success so far, particularly in small children. We created an animal model to investigate whether pulsatile or continuous flow would be superior. Three 1 month old sheep (10-16 kg) were instrumented. Via sternotomy and with cardiopulmonary bypass, a large ventricular septal defect and atrial septal defect were created. The left ventricle was cannulated using a Berlin Heart inflow cannula. This was connected sequentially to a continuous flow device (Thoratec HeartMate X, Pleasanton, CA) and to a pulsatile device (Berlin Heart Excor, The Woodlands, TX). Outflow was via a Y-graft to both aorta and pulmonary artery, striving for equal flow to both. Atrial filling pressures were controlled with volume infusions over a wide range. Under comparable loading conditions, significantly higher maximum flow was obtained by HeartMate X than by Excor (4.95 ± 1.27 L/min [range, 3.84-6.34 L/min] for HeartMate X vs. 1.80 ± 0.85 L/min [range, 1.01-2.7 L/min] for Excor; p < 0.05). Judging from this limited animal study, in single ventricle scenarios, continuous flow devices may achieve higher pump flows than pulsatile devices when provided with simila...Continue Reading

References

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Oct 5, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ye FanRoland Hetzer
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Citations

Jan 27, 2016·Seminars in Thoracic and Cardiovascular Surgery·Y Joseph Woo, Bruce A Reitz
Mar 5, 2017·The Journal of Thoracic and Cardiovascular Surgery·Katsuhide Maeda
Feb 14, 2019·Paediatric Anaesthesia·Manchula NavaratnamSeth A Hollander
Mar 14, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Sharon ChenKatsuhide Maeda
Mar 30, 2016·Current Opinion in Cardiology·Karolina K MarinescuSirtaz Adatya
Jun 18, 2017·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Masahiro Nishida

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