@article{2981169,
    title = "Salutary effects of the Pulvad, a novel implantable counterpulsation assist device, on cardiac mechanoenergetics",
    author = "Kontogiannis, C. and Aravantinos, D. and Nanas, I. and Kapelios, C.J. and Marinakis, S. and Vakrou, S. and Sarchosi, S. and Perrea, D.N. and Mason, J.W. and Nanas, J.N. and Malliaras, K.",
    journal = "ASAIO journal (American Society for Artificial Internal Organs : 1992)",
    year = "2019",
    volume = "65",
    number = "5",
    pages = "473-480",
    publisher = "Lippincott Williams and Wilkins",
    doi = "10.1097/MAT.0000000000000838",
    keywords = "Blood pressure;  Blood vessels;  Energy utilization;  Heart;  Hemodynamics;  Left ventricular assist devices;  Mammals;  Pneumatic drives;  Unloading, Aortic pressure;  Coronary blood flows;  Counterpulsation;  Ejection fraction;  Left ventricular;  Long-term testing;  Mechanical performance;  Pressure volumes, Blood, animal experiment;  animal model;  aortic pressure;  Article;  ascending aorta;  blood flow;  brain circulation;  controlled study;  coronary artery blood flow;  electrocardiogram;  end-diastolic pressure-volume relationship;  end-systolic pressure-volume relationship;  energy consumption;  heart afterload;  heart hemodynamics;  heart left ventricle mechanoenergetics;  heart muscle ischemia;  heart output;  heart right atrium pressure;  heart stroke volume;  left anterior descending coronary artery;  nonhuman;  perfusion pressure;  priority journal;  animal;  counterpulsation;  devices;  heart assist device;  heart failure;  heart left ventricle function;  hemodynamics;  pathophysiology;  physiology;  pig;  procedures, Animals;  Counterpulsation;  Heart Failure;  Heart-Assist Devices;  Hemodynamics;  Swine;  Ventricular Function, Left",
    abstract = "The Pressure Unloading Left Ventricular Assist Vevice (PULVAD) is a novel implantable counterpulsation LVAD, designed to provide ventricular unloading with augmentation of LV performance and retention of pulsatility. We assessed the effects of the PULVAD on hemodynamics and LV mechanoenergetics in seven farm pigs with acute ischemic heart failure. The PULVAD was implanted in the thorax and was connected to the ascending aorta. The PULVAD was pneumatically driven by a standard intra-aortic balloon pump console and was electrocardiogram-synchronized to provide LV pressure unloading along with diastolic aortic pressure augmentation. Hemodynamics, indices of LV mechanoenergetics, and coronary blood flow were measured without and after brief PULVAD support. PULVAD support decreased LV afterload and improved LV mechanical performance (increased ejection fraction, stroke volume, cardiac output and maximum elastance). The PULVAD concurrently reduced LV energy consumption (decreased stroke work and pressure-volume area) and optimized LV energetic performance (improved the ratio of stroke work to pressure-volume area). PULVAD support increased mean coronary blood flow, through dramatic augmentation of diastolic blood flow. In conclusion, the PULVAD unloads the failing LV, optimizes LV mechanoenergetics, and augments coronary blood flow. These salutary effects of short-term PULVAD support provide the foundation for long-term testing. © 2018 by the ASAIO."
}