Hemodynamic support with the pulsatile catheter pump in a sheep model of acute heart failure

This study was aimed to mimic clinical heart failure (HF) conditions and to assess the effect of pulsatile catheter (PUCA) pump support on hemodynamics and tissue perfusion in a sheep model of acute HF. In 14 sheep, HF was induced by partial occluding the middle left circumflex coronary artery combined with pacemaker-induced tachycardia. PUCA pump was then activated to support the HF for 3 h. Hemodynamic parameters were recorded at baseline, HF, and then every 30 min during experiments. Blood samples were taken in carotid artery (CA), pulmonary artery (PA), and coronary sinus (CS) for the determination of oxygen saturation (SO2) and lactate concentration as markers of tissue perfusion. Results showed that HF model was induced successfully in 10 sheep and failed in four sheep due to refractory ventricular fibrillation. PUCA pump support was successful in seven out of 10 sheep for 3 h. Three cases failed due to technical problems. After HF (n = 10), cardiac output (CO) was decreased from 3.7 +/- 0.5 to 2.0 +/- 0.5 L/min (P < 0.001). Mean arterial pressure (MAP) was lowered from 116.1 +/- 14.2 to 68.1 +/- 14.7 mm Hg (P < 0.001). In seven sheep supported with PUCA pump, MAP rose from 68.9 +/- 15.2 to 94.7 +/- 14.7 mm Hg (P = 0.005), systolic blood pressure increased from 86.6 +/- 17.0 to 112.6 +/- 17.1 mm Hg (P = 0.009), and diastolic blood pressure increased from 57.7 +/- 12.6 to 79.9 +/- 13.9 mm Hg (P = 0.011). CO remained at about 2.0 L/min. SO2 in CA, PA, and CS decreased significantly after HF (P < 0.001), with an increase after support (compared with HF, P < 0.001, 0.066 and 0.114, respectively). Lactate concentrations increased gradually in CA, PA, and CS toward the end of experiments without difference among different sampling sites. This HF model in sheep is simple, easy to manipulate, reproducible and reflecting clinical HF conditions. PUCA pump can maintain the hemodynamic status for 3 h in this acute HF model.