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Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study

BACKGROUND: Right ventricular failure (RVF) and -support is associated with poor results. We aimed for a new approach of right - sided assistance bypassing the right ventricle and pulmonary circulation in order to better decompress the right ventricle and optimize left ventricular filling. METHODS:...

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Autores principales: Spillner, Jan, Stoppe, Christian, Hatam, Nima, Amerini, Andrea, Menon, Ares, Nix, Christoph, Steinseifer, Ulrich, Abusabha, Yousef, Giessen, Hanna, Autschbach, Rüdiger, Haushofer, Marcus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293723/
https://www.ncbi.nlm.nih.gov/pubmed/22309934
http://dx.doi.org/10.1186/1749-8090-7-15
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author Spillner, Jan
Stoppe, Christian
Hatam, Nima
Amerini, Andrea
Menon, Ares
Nix, Christoph
Steinseifer, Ulrich
Abusabha, Yousef
Giessen, Hanna
Autschbach, Rüdiger
Haushofer, Marcus
author_facet Spillner, Jan
Stoppe, Christian
Hatam, Nima
Amerini, Andrea
Menon, Ares
Nix, Christoph
Steinseifer, Ulrich
Abusabha, Yousef
Giessen, Hanna
Autschbach, Rüdiger
Haushofer, Marcus
author_sort Spillner, Jan
collection PubMed
description BACKGROUND: Right ventricular failure (RVF) and -support is associated with poor results. We aimed for a new approach of right - sided assistance bypassing the right ventricle and pulmonary circulation in order to better decompress the right ventricle and optimize left ventricular filling. METHODS: From a microaxial pump (Abiomed), a low resistance oxygenator (Maquet and Novalung) and two cannulas (28 and 27 Fr) a system was set up and evaluated in an ovine model (n = 7). Connection with the heart was the right and left atrium. One hour the system was operated without RVF and turned of again. Then a RVF was induced and the course with the system running was evaluated. Complete hemodynamic monitoring was performed as well as echocardiography, flow measurement and blood gas analysis. RESULTS: The overall performance of the system was reliable. Without RVF no relevant changes of hemodynamics occurred; blood gases were supra normal. In RVF a cardiogenic shock developed (MAP 35 ± 13 mmHg, CO 1,1 ± 0,7 l/min). Immediately after starting the system the circulation normalized (significant increase of MAP to 85 ± 13 mmHg, of CO to 4,5 ± 1,9). Echocardiography also revealed right ventricular recovery. After stopping the system, RVF returned. CONCLUSIONS: Bypassing the right ventricle and pulmonary circulation with an oxygenating assist device, which may offer the advantages of enhanced right ventricular decompression and augmented left atrial filling, is feasible and effective in the treatment of acute RVF. Long time experiments are needed.
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spelling pubmed-32937232012-03-06 Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study Spillner, Jan Stoppe, Christian Hatam, Nima Amerini, Andrea Menon, Ares Nix, Christoph Steinseifer, Ulrich Abusabha, Yousef Giessen, Hanna Autschbach, Rüdiger Haushofer, Marcus J Cardiothorac Surg Research Article BACKGROUND: Right ventricular failure (RVF) and -support is associated with poor results. We aimed for a new approach of right - sided assistance bypassing the right ventricle and pulmonary circulation in order to better decompress the right ventricle and optimize left ventricular filling. METHODS: From a microaxial pump (Abiomed), a low resistance oxygenator (Maquet and Novalung) and two cannulas (28 and 27 Fr) a system was set up and evaluated in an ovine model (n = 7). Connection with the heart was the right and left atrium. One hour the system was operated without RVF and turned of again. Then a RVF was induced and the course with the system running was evaluated. Complete hemodynamic monitoring was performed as well as echocardiography, flow measurement and blood gas analysis. RESULTS: The overall performance of the system was reliable. Without RVF no relevant changes of hemodynamics occurred; blood gases were supra normal. In RVF a cardiogenic shock developed (MAP 35 ± 13 mmHg, CO 1,1 ± 0,7 l/min). Immediately after starting the system the circulation normalized (significant increase of MAP to 85 ± 13 mmHg, of CO to 4,5 ± 1,9). Echocardiography also revealed right ventricular recovery. After stopping the system, RVF returned. CONCLUSIONS: Bypassing the right ventricle and pulmonary circulation with an oxygenating assist device, which may offer the advantages of enhanced right ventricular decompression and augmented left atrial filling, is feasible and effective in the treatment of acute RVF. Long time experiments are needed. BioMed Central 2012-02-06 /pmc/articles/PMC3293723/ /pubmed/22309934 http://dx.doi.org/10.1186/1749-8090-7-15 Text en Copyright ©2012 Spillner et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Spillner, Jan
Stoppe, Christian
Hatam, Nima
Amerini, Andrea
Menon, Ares
Nix, Christoph
Steinseifer, Ulrich
Abusabha, Yousef
Giessen, Hanna
Autschbach, Rüdiger
Haushofer, Marcus
Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study
title Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study
title_full Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study
title_fullStr Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study
title_full_unstemmed Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study
title_short Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study
title_sort feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293723/
https://www.ncbi.nlm.nih.gov/pubmed/22309934
http://dx.doi.org/10.1186/1749-8090-7-15
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