Taylor A J, Edwards F H, Macon M G, Worley B, Graeber G M
Departments of Medicine, Walter Reed Army Medical Center, Washington, DC.
J Extra Corpor Technol. 1990;22(2):85-90.
To compare the efficiency of pulmonary artery balloon counterpulsation and a centrifugal flow pump in reversing the hemodynamic consequences of acute right-sided heart failure, we employed both devices in 14 Yorkshire pigs in which right ventricular infarction was created via surgical ligation of branches of the right coronary artery. Pulmonary artery balloon counterpulsation improved some of the indicators of right heart failure, as manifested by significantly decreased right atrial pressure and increased mean systemic blood pressure. In contrast, the centrifugal flow pump consistently and significantly reversed all of the hemodynamic consequences of right ventricular infarction. In comparison to pulmonary artery balloon counterpulsation, the centrifugal flow pump resulted in lower right atrial pressures (p=0.020), lower mean pulmonary pressures (p less than 0.0001), increased left atrial pressures (p=0.026), increased cardiac output (p less than 0.0001), and increased mean systemic blood pressures (p less than 0.0001). Possible mechanisms to explain the superiority of the centrifugal flow pump include better hemodynamic unloading of the failing myocardium and independence from right ventricular output.
为比较肺动脉球囊反搏与离心式血泵逆转急性右心衰竭血流动力学后果的效率，我们在14只约克夏猪身上使用了这两种装置，这些猪通过手术结扎右冠状动脉分支造成右心室梗死。肺动脉球囊反搏改善了一些右心衰竭指标，表现为右心房压力显著降低和平均体循环血压升高。相比之下，离心式血泵持续且显著地逆转了右心室梗死的所有血流动力学后果。与肺动脉球囊反搏相比，离心式血泵导致右心房压力更低（p = 0.020）、平均肺动脉压力更低（p < 0.0001）、左心房压力升高（p = 0.026）、心输出量增加（p < 0.0001）以及平均体循环血压升高（p < 0.0001）。解释离心式血泵优越性的可能机制包括衰竭心肌更好的血流动力学卸载以及不依赖右心室输出。
