Koenig Steven C, Litwak Kenneth N, Giridharan Guruprasad A, Pantalos George M, Dowling Robert D, Prabhu Sumanth D, Slaughter Mark S, Sobieski Michael A, Spence Paul A
Department of Bioengineering, Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky 40202, USA.
ASAIO J. 2008 Nov-Dec;54(6):578-84. doi: 10.1097/MAT.0b013e318186891f.
The acute hemodynamic efficacy of an implantable counterpulsation device (CPD) was evaluated. The CPD is a valveless single port, 32-ml stroke volume blood chamber designed to be connected to the human axillary artery using a simple surface surgical procedure. Blood is drawn into the pump during systole and ejected during diastole. The acute hemodynamic effects of the 32-ml CPD were compared to a standard clinical 40-ml intra-aortic balloon pump (IABP) in calves (80 kg, n = 10). The calves were treated by a single oral dose of Monensin to produce a model of diminished cardiac function (DCF). The CPD and IABP produced similar increases in cardiac output (6% CPD vs. 5% IABP, p > 0.5) and reduction in left ventricular external work (14% CPD vs. 13% IABP, p > 0.5) compared to DCF (p < 0.05). However, the ratio of diastolic coronary artery flow to left ventricular external work increase from DCF baseline (p < 0.05) was greater with the CPD compared to the IABP (15% vs. 4%, p < 0.05). The CPD also produced a greater reduction in left ventricular myocardial oxygen consumption from DCF baseline (p < 0.05) compared to the IABP (13% vs. 9%, p < 0.05) despite each device providing similar improvements in cardiac output. There was no early indication of hemolysis, thrombus formation, or vascular injury. The CPD provides hemodynamic efficacy equivalent to an IABP and may become a therapeutic option for patients who may benefit from prolonged counterpulsation.
对一种可植入式反搏装置（CPD）的急性血流动力学疗效进行了评估。该CPD是一种无瓣单端口、每搏输出量为32毫升的血腔，设计通过简单的体表外科手术连接至人体腋动脉。血液在收缩期被泵入泵内，在舒张期被泵出。将32毫升CPD的急性血流动力学效应与标准临床使用的40毫升主动脉内球囊泵（IABP）在犊牛（80千克，n = 10）中进行比较。给犊牛单次口服莫能菌素以建立心功能减退（DCF）模型。与DCF相比，CPD和IABP使心输出量有相似的增加（CPD增加6%，IABP增加5%，p>0.5），左心室外部做功有相似的减少（CPD减少14%，IABP减少13%，p>0.5）（p<0.05）。然而，与IABP相比，CPD使舒张期冠状动脉血流与左心室外部做功之比从DCF基线增加得更多（p<0.05）（15%对4%，p<0.05）。尽管两种装置在心输出量方面提供了相似的改善，但与IABP相比，CPD使左心室心肌氧耗从DCF基线减少得更多（p<0.05）（13%对9%，p<0.05）。没有早期溶血、血栓形成或血管损伤的迹象。CPD提供了与IABP相当的血流动力学疗效，可能成为受益于延长反搏治疗的患者的一种治疗选择。
