Shi C, Zhou D-D, Liu G, Zhang L, Meng J-J, Geng Y, Liu X-G
Department of Cardiothoracic Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui province, China.
Eur Rev Med Pharmacol Sci. 2015 May;19(10):1859-65.
To evaluate the hemodynamic characteristics and biocompatibility of a new para-aortic counterpulsation device in animal experiment studies.
Para-aortic counterpulsation device (PACD), a monoport device, consists of a blood chamber anastomosed to the descending aorta by means of a valveless graft and an air chamber connected to IABP machine. Hemodynamic parameters during the PACD-assisted beats were compared with those during the unassist beats. Acute heart failure was induced in all animals, and the hemodynamic effects of PACD were then reassessed.
We successfully induced heart failure in all cases, in conditions of which cardiac output (CO) and MAP decreased 17.6% and 27.7% respectively, and PCWP increased 57.7%. Hemodynamic indexes, cerebral and heart perfusion improved significantly after PACD assisting. PACD activation increased significantly CO and MAP 6.29% and 2.04% respectively. Both of SAP and DAP decreased significantly from 85.00 to 81.88 mmHg and 59.63 to 54.63 respectively, at the same time, MADP increased 19.4%, after PACD assist. The value of MDLMF, LMF and CSF was increased by 14.0%, 13.8% and 11.6% respectively. LCAF increased by 11.23%, after PACD assist. The PFH increased significantly in the first six hours. There was no statistically significant difference in the last two hours. When the acute animal experiments were completed, there were no infarct ischemic, thrombosis change in organs by Gross and histologic observation.
PACD with good biological compatibility significantly reduced the left ventricular afterload, increased diastolic arterial pressure and myocardial perfusion, improved heart function and cerebral perfusion.
在动物实验研究中评估一种新型主动脉旁反搏装置的血流动力学特性和生物相容性。
主动脉旁反搏装置（PACD）是一种单端口装置，由通过无瓣移植物与降主动脉吻合的血腔和连接到主动脉内球囊反搏（IABP）机器的气腔组成。将PACD辅助搏动期间的血流动力学参数与未辅助搏动期间的参数进行比较。在所有动物中诱导急性心力衰竭，然后重新评估PACD的血流动力学效应。
我们在所有病例中成功诱导了心力衰竭，在此情况下心输出量（CO）和平均动脉压（MAP）分别下降了17.6%和27.7%，肺毛细血管楔压（PCWP）升高了57.7%。PACD辅助后，血流动力学指标、脑灌注和心脏灌注均显著改善。PACD激活后，CO和MAP分别显著增加6.29%和2.04%。PACD辅助后，收缩压（SAP）和舒张压（DAP）均显著下降，分别从85.00 mmHg降至81.88 mmHg和从59.63 mmHg降至54.63 mmHg，同时平均动脉舒张压（MADP）增加了19.4%。PACD辅助后，心肌舒张末期最小血流速度（MDLMF）、左室心肌血流（LMF）和冠脉血流储备分数（CSF）的值分别增加了14.0%、13.8%和11.6%。左冠状动脉血流（LCAF）增加了11.23%。在前六个小时内血小板功能指标（PFH）显著增加。在最后两小时内无统计学显著差异。急性动物实验完成后，通过大体和组织学观察，各器官均未出现梗死缺血、血栓形成变化。
具有良好生物相容性的PACD显著降低了左心室后负荷，增加了舒张期动脉压和心肌灌注，改善了心功能和脑灌注。
