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Abdominal Aorta01:25

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Once the aorta traverses the diaphragmatic plane at the aortic hiatus, it is known as the abdominal aorta. This anatomical structure is positioned leftward of the spinal column, encased within a cocoon of adipose tissue behind the peritoneal cavity. It terminates at the L4 vertebra, where it splits into the common iliac arteries. Prior to this bifurcation, the abdominal aorta gives rise to several vital branches.
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Development of "plug and play" TransApical to aorta VAD.

Dongfang Wang1, Joseph B Zwischenberger, Xiaoqin Zhou

  • 1Cardiothoracic Surgery, The University of Texas Medical Branch, Galveston, Texas 77555-0258, USA.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
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Summary

This study introduces a minimally invasive Transapical to Aorta pump for left ventricular (LV) assist. The device effectively unloads the left ventricle with minimal blood trauma in sheep.

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Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Medical Devices

Background:

  • Left ventricular assist devices (LVADs) are crucial for managing heart failure.
  • Minimally invasive approaches for LVAD implantation are highly desirable to reduce patient morbidity.
  • The transapical to aorta (TAA) approach offers a direct route for LVAD insertion.

Purpose of the Study:

  • To evaluate the feasibility, safety, and efficacy of a novel Transapical to Aorta (TAA) pump for left ventricular (LV) unloading.
  • To assess the hemodynamic performance and potential for blood trauma associated with the TAA pump.

Main Methods:

  • A novel TAA pump with a flexible conduit and integrated turbine was implanted in six healthy sheep via left thoracotomy.
  • The pump was inserted from the cardiac apex through the LV into the ascending aorta.
  • Hemodynamic parameters including aortic and LV pressures, pump flow, motor current, and plasma free hemoglobin were continuously monitored.

Main Results:

  • Pump implantation was rapid (<15 minutes) and successful in all subjects.
  • The TAA pump achieved significant left ventricular unloading, reducing LV systemic pressure from 102.5 to 58.8 mm Hg (p=0.042).
  • Blood flow ranged from 2.8 to 4.4 L/min against a mean arterial pressure of 86 mm Hg, with minimal hemolysis (4 mg/dl free hemoglobin) and no observed thrombosis.

Conclusions:

  • The Transapical to Aorta pump is a quick, reliable, and minimally invasive LV assist device.
  • This approach achieves significant left ventricular unloading with minimal blood trauma.
  • The TAA pump demonstrates potential as an effective therapeutic option for heart failure patients.