A novel subcutaneous counterpulsation device: Acute hemodynamic efficacy during pharmacologically induced hypertension, hypotension, and heart failure

Carlo R. Bartoli, Gregory C. Wilson, Guruprasad A. Giridharan, Mark S. Slaughter, Leslie C. Sherwood, Paul A. Spence, Sumanth D. Prabhu, Steven C. Koenig

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

The miniaturization of mechanical assist devices and less invasive implantation techniques may lead to earlier intervention in patients with heart failure. As such, we evaluated the effectiveness of a novel, minimally invasive, implantable counterpulsation device (CPD) in augmenting cardiac function during impaired hemodynamics. We compared the efficacy of a 32-mL stroke volume CPD with a standard 40-mL intra-aortic balloon pump (IABP) over a range of clinically relevant pathophysiological conditions. Male calves were instrumented via thoracotomy, the CPD was anastomosed to the left carotid artery, and the IABP was positioned in the descending aorta. Hemodynamic conditions of hypertension, hypotension, and heart failure were pharmacologically simulated and data were recorded during CPD and IABP support (off, 1:2, 1:1 modes) for each condition. In all three pathophysiological conditions, the CPD and IABP produced similar and statistically significant (P < 0.05) increases in coronary artery blood flow normalized to the left ventricular (LV) workload. During hypotension and heart failure conditions, however, the CPD produced significantly greater reductions in LV workload and myocardial oxygen consumption as compared with the IABP. A novel 32-mL CPD connected to a peripheral artery produced equivalent or greater hemodynamic benefits than a standard 40-mL IABP during pharmacologically induced hypertension, hypotension, and heart failure conditions.

Original languageEnglish
Pages (from-to)537-545
Number of pages9
JournalArtificial Organs
Volume34
Issue number7
DOIs
StatePublished - Jul 2010

Keywords

  • Cardiac surgery
  • Counterpulsation
  • Counterpulsation device
  • Heart failure
  • Intra-aortic balloon pump

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