Vandenberghe Stijn, Nishida Takahiro, Segers Patrick, Meyns Bart, Verdonck Pascal
Institute Biomedical Technology, Ghent University, Ghent, Belgium.
Artif Organs. 2004 Jul;28(7):660-7. doi: 10.1111/j.1525-1594.2004.07374.x.
Ventricular assist devices are gaining ground in the therapeutic treatment of chronic heart failure. These devices are sometimes used as a bridge to recovery by unloading the left ventricle (LV) and restoring its function. It is therefore important to preserve the heart muscle and apply less invasive implantation methods.
In this study ventricular unloading was achieved in 7 healthy sheep with a rotary blood pump at different pump flow levels. Ventricular cannulation via the left atrium (LA) and through the mitral valve was compared to atrial cannulation. The unloading of the heart was assessed with LV pressure-volume loops, derived energetic parameters, and an estimate of LV wall stress.
No significant difference between the cannulations was found for any flow or pressure. LA cannulation, however, resulted in significantly lower stroke volumes and stroke work for all pump flow levels. Irrespective of cannulation site, LV volumes and energetic parameters showed a significant decrease with increasing pump flow.
LV assist with a rotary blood pump can provide sufficient unloading with atrial cannulation.
心室辅助装置在慢性心力衰竭的治疗中越来越受到重视。这些装置有时被用作恢复的桥梁，通过减轻左心室（LV）的负荷并恢复其功能。因此，保护心肌并采用侵入性较小的植入方法很重要。
在本研究中，使用旋转血泵在7只健康绵羊身上以不同的泵流量水平实现心室卸载。将经左心房（LA）并通过二尖瓣的心室插管与心房插管进行比较。通过左心室压力-容积环、导出的能量参数和左心室壁应力估计来评估心脏的卸载情况。
在任何流量或压力下，插管之间均未发现显著差异。然而，对于所有泵流量水平，LA插管导致的心输出量和每搏功显著降低。无论插管部位如何，随着泵流量增加，左心室容积和能量参数均显著降低。
使用旋转血泵进行左心室辅助可通过心房插管提供足够的卸载。
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