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Related Experiment Videos

End-organ function during chronic nonpulsatile circulation.

Satoshi Saito1, Stephen Westaby, David Piggot

  • 1Oxford Heart Centre and Department of Cellular Pathology, United Kingdom. satoyum@aol.com

The Annals of Thoracic Surgery
|October 29, 2002
PubMed
Summary
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Chronic nonpulsatile circulation from left ventricular assist devices was well tolerated in sheep, showing no end-organ damage. However, elevated renin levels and aortic wall thinning warrant further investigation for long-term safety.

Area of Science:

  • Biomedical Engineering
  • Cardiovascular Research
  • Medical Device Technology

Background:

  • Continuous flow left ventricular assist devices (LVADs) offer user-friendly options for heart failure management.
  • Concerns remain regarding the long-term safety of chronic nonpulsatile blood flow generated by these devices.

Purpose of the Study:

  • To evaluate the safety and impact of chronic nonpulsatile circulation on end-organ function in a sheep model.
  • To compare the effects of nonpulsatile flow from a magnetically suspended centrifugal pump against pulsatile flow.

Main Methods:

  • A sheep model was used with implantation of a Terumo magnetically suspended centrifugal pump to achieve nonpulsatile flow.
  • Animals were monitored for end-organ function (hepatic, renal) and plasma renin levels, with detailed histologic examination of major organs and arteries post-sacrifice.

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Main Results:

  • No significant functional or histologic differences were observed in major end organs between nonpulsatile and control groups.
  • Plasma renin levels were significantly elevated in the nonpulsatile group, indicating renin-angiotensin system upregulation.
  • A significant thinning of the medial layer of the ascending aorta was noted in animals with nonpulsatile circulation.

Conclusions:

  • Chronic nonpulsatile circulation appears to be well-tolerated in the short-to-medium term, with no detectable end-organ damage.
  • The observed renin-angiotensin system activation and aortic wall changes necessitate further investigation for long-term safety assessment.
  • Current findings support the potential for safe long-term use of nonpulsatile LVADs for circulatory support.