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Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics
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Pulmonic valve function during thoracic artificial lung attachment.

Alexander S Kuo1, Carrie E Perlman, Lyle F Mockros

  • 1Department of Surgery and Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|March 22, 2008
PubMed
Summary
This summary is machine-generated.

Pulmonic valve incompetence during total artificial lung (TAL) implantation is linked to pulmonary resistance. Maintaining resistance below 5 mm Hg/(L/min) is crucial for preventing valve issues and right ventricular dysfunction.

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Area of Science:

  • Biomedical Engineering
  • Cardiovascular Physiology
  • Respiratory Mechanics

Background:

  • Pulmonic valve incompetence is a potential complication during total artificial lung (TAL) implantation.
  • This incompetence may contribute to right ventricular dysfunction depending on the attachment mode.

Purpose of the Study:

  • To investigate the impact of pulmonary system resistance and inertia on pulmonic valve function during TAL implantation.
  • To identify critical thresholds for pulmonary resistance to prevent valve incompetence.

Main Methods:

  • Retrospective analysis of data from prototype TAL attachments in six pigs.
  • TAL was connected in parallel, series, and hybrid configurations with natural lungs.
  • Quantified periods of ejection, regurgitation, sealed valve, and regurgitant fraction.

Main Results:

  • High pulmonary system resistance (R) significantly increased pulmonic valve incompetence and regurgitation.
  • A negative inertial pressure drop (DeltaPI) decreased regurgitation by extending ejection time.
  • Pulmonic regurgitant fraction remained stable below R <5 mm Hg/(L/min).
  • The relationship for R >5 mm Hg/(L/min) was Fr = 0.014R + 0.011DeltaPI + 0.15 (R = 0.82).

Conclusions:

  • Pulmonary system resistance must be kept below 5 mm Hg/(L/min) to avoid pulmonic valve incompetence.
  • While high device inertance reduced regurgitation, it increased pulmonary impedance and ventricular workload.
  • TAL design should prioritize minimizing effective pulmonary system resistance.