An abdominal left ventricular assist device: preclinical studies.

Area of Science:

• Cardiovascular Engineering
• Medical Devices
• Surgical Innovation

Background:

• Left ventricular assist devices (LVADs) are crucial for managing heart failure.
• Abdominally positioned LVADs offer an alternative surgical approach.
• Pneumatically actuated bladder pumps represent a specific LVAD design.

Purpose of the Study:

• To evaluate the efficacy and physiological effects of an abdominally positioned left ventricular assist device (ALVAD).
• To assess the ALVAD's impact on left ventricular function and systemic hemodynamics in a preclinical model.

Main Methods:

• An abdominally positioned left ventricular assist device (ALVAD) was implanted in 25 calves (mean weight 99 ± 12 kg).
• The ALVAD, a pneumatically actuated bladder pump, connected the left ventricular apex to the infrarenal abdominal aorta.
• Hemodynamic parameters, including left ventricular pressure, cardiac output, and stroke volume, were monitored.

Main Results:

• The ALVAD significantly decreased left ventricular pressure, dP/dt, and stroke work.
• Systemic perfusion indices, such as peak aortic pressure, stroke volume, and cardiac output, were increased.
• Postoperative cardiac catheterization and left ventriculograms confirmed improved ejection fraction and device effectiveness.

Conclusions:

• The abdominally positioned left ventricular assist device (ALVAD) effectively assumes left ventricular function and provides hemodynamic support.
• The device demonstrated sustained effectiveness over extended periods in the calf model.
• The ALVAD is suitable for short-term clinical use in patients with reversible left ventricular failure.