Related Experiment Videos
Centrifugal pump or pneumatic ventricle for short-term mechanical circulatory support?
1Centre de Recerches chirurgicales, CNRS UA 591, Association Claude Bernard, Faculté de Médecine, CHU H. Mondor.
Insights
The Centrimed centrifugal pump (CP) and UTAH 85 VAD showed similar clinical response and blood damage in calves. CP requires daily replacement, making the UTAH 85 VAD more cost-effective for short-term support.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Medical Devices
Background:
- Left ventricular assist devices (LVADs) are crucial for managing heart failure.
- Comparing different LVADs is essential for optimizing patient outcomes.
- Holstein calves serve as a relevant model for preclinical VAD studies.
Purpose of the Study:
- To compare the efficacy and safety of the Centrimed centrifugal pump (CP) and the UTAH 85 VAD.
- To evaluate hemodynamic performance, blood trauma, and technical reliability of both devices.
- To assess the suitability of these LVADs for short-term mechanical circulatory support.
Main Methods:
- Two groups of four Holstein calves were implanted with either the CP or the UTAH 85 VAD.
- Standardized operative procedures, monitoring, and anticoagulation protocols were employed.
- Hemodynamic parameters, blood markers, and autopsy findings were analyzed post-implantation.
Main Results:
- Both devices achieved complete and identical left ventricular unloading.
- LV bypassed flow rate was higher in CP, but without statistical significance.
- Comparable blood trauma, platelet loss, and lactate dehydrogenase levels were observed.
- Similar rates of thrombotic deposits and renal infarction were found at autopsy.
- CP required daily housing changes, while the UTAH 85 VAD showed no technical failures.
Conclusions:
- The CP and UTAH 85 VAD demonstrated comparable clinical response and blood damage.
- The UTAH 85 VAD presents a potentially more cost-effective option due to its reliability.
- Valveless, low-cost CP devices are attractive for short-term mechanical support until the UTAH-85 VAD is commercially available.
Abstract:
Two comparable groups of four Holstein calves were implanted with different left ventricle assist devices: the Centrimed centrifugal pump (CP) (Sarns Inc.) or the UTAH 85 VAD pneumatic ventricle (University of Utah). Operative procedure, inflow and outflow cannulae, monitoring, heparinization, were identical in both groups. No transfusion was ever required. The study was terminated after three days and autopsy was performed on the calves. Left ventricular unloading provided by both devices was complete (LVEDP less than 1 mmHg) and identical. LV bypassed flow rate was higher in CP (0.045 L/min/kg) than in UTAH 85 VAD (0.035 L/min/kg) but with no statistical difference. Blood trauma was comparable in the two groups. Daily blood samples did not show any significant changes from baseline values in creatinine, hematocrit, fibrinogen. Platelet loss from initial level was 30%; serum lactate dehydrogenase rose 150% with no significant difference in the two groups; plasma free hemoglobin never reached significant values. At autopsy, thrombotic deposits on cannuale and renal infarction rate were similar. CP housing had to be changed every day, whereas no technical failure was ever observed with the UTAH 85 VAD. Clinical response and blood damage of the two pumps used as LVAD were the same. Considering the CP has to be replaced every 24 h, the cost of three CP's would be comparable to one Utah UVAD-85 if polyurethane tricusp semi-lunar valves are used in the latter. Until the UTAH-85 VAD becomes commercially available, simple valveless low-cost CP are very attractive for short-term mechanical support.