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Effect of synchronous and asynchronous pulsatile flow during left, right, and biventricular bypass
D J Cohen1, D G Genecov, M F Clem
1Department of Surgery, University of Texas Health Science Center, San Antonio 78284-7841.
ASAIO Transactions
|July 1, 1991
Summary
Biventricular assist devices (BiVAD) in asynchronous mode significantly reduce myocardial oxygen consumption (MVO2) during cardiac recovery. Synchronous counterpulsation did not decrease MVO2, suggesting asynchronous BiVAD is optimal for aiding heart recovery.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Cardiac Physiology
Background:
- Ventricular assist devices (VADs) support cardiac output during recovery from surgery or myocardial infarction.
- VADs can operate in asynchronous (full-to-empty) or synchronous (counter-pulsation) modes.
- Optimal VAD mode for reducing myocardial oxygen consumption (MVO2) requires investigation.
Purpose of the Study:
- To compare the efficacy of asynchronous versus synchronous VAD modes in reducing MVO2.
- To determine the optimal VAD configuration (left, right, or biventricular assist) for myocardial recovery.
Main Methods:
- Eighteen pigs were instrumented to measure MVO2 via cardiac catheterization.
- Pierce-Donachy VADs were used in left, right, or biventricular assist configurations.
- Periods of control, synchronous, and asynchronous bypass were compared before and after coronary artery ligation.
Main Results:
- Only the biventricular assist device (BiVAD) in asynchronous mode showed a statistically significant reduction in MVO2 compared to controls.
- Synchronized counterpulsation did not decrease MVO2.
- Asynchronous biventricular support was most effective in reducing myocardial oxygen demand.
Conclusions:
- Asynchronous biventricular assist is the preferred mode for VADs aimed at aiding cardiac recovery postoperatively or post-myocardial infarction.
- This mode optimizes myocardial oxygen supply-demand balance, promoting heart recovery.