Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Aravantinos Dionysios
Dissertation committee:
Περρέα Δέσποινα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Νανάς Ιωάννης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ηλιοδρομίτης Ευστάθιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ραλλίδης Λουκιανός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλεξόπουλος Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Οικονομίδης Ιγνάτιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αγγουράς Δημήτριος, Αν. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η επίδραση της παραορτικής αντλίας αντιώθησης (PU-LVAD) στη στεφανιαία ροή και στη ροή στις καρωτίδες σε χοίρειο μοντέλο οξείας καρδιακής ανεπάρκειας
Translated title:
Effect of pressure unloading left ventricular assist device (PULVAD) on coronary and carotid blood flow in a porcine model of acute heart failure
Summary:
Introduction: We have developed the Pressure Unloading Left Ventricular Assist Device (PULVAD), a novel implantable counterpulsation device, designed to provide left ventricular (LV) pressure unloading with augmentation of LV performance and retention of pulsatility.
Methods: Seven farm pigs (75-95 kg) underwent PULVAD implantation and induction of acute heart failure by left anterior descending artery (LAD) ligation for 60 minutes, followed by reperfusion. PULVAD was driven by a standard intra-aortic balloon pump console. Pigs were instrumented with Millar catheter, sonomicrometry crystals and a Doppler flow probe placed around LAD and common carotid artery. Coronary and carotid blood flow were measured without and after brief (<60 secs) PULVAD support during reperfusion.
Results: While PULVAD support decreased LAD blood flow during systole (from 32.5±13.9 to 11.0±28.0ml/min; p = 0.090), it dramatically increased LAD blood flow during diastole (from 62.4±31.4 to 98.3±36.3, p = 0.001), resulting in a net significant increase in mean LAD blood flow (from 50.8 ± 23.4 to 64.6 ± 24.2, p = 0.034). In contrast, blood flow in the common carotid remained unaffected by PULVAD support (PULVAD off: 88.0 ± 55.8 vs. PULVAD on: 85.1 ± 56.1, p = 0.173).
Conclusion: PULVAD support increases mean coronary blood flow during reperfusion, through dramatic augmentation of coronary blood flow during diastole. Blood flow in the common carotid remained unaffected by PULVAD support indicating the intact autoregulatory capacity of the cerebral circulation.
Main subject category:
Health Sciences
Keywords:
Counter pulsation, Heart failure, Coronary blood flow, Carotid blood flow
Number of references:
144
