Individualized Biventricular Epicardial Augmentation Technology in a Drug-Induced Porcine Failing Heart Model

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Medical Devices

Background:

• Current advanced heart failure treatments like cardiac transplantation and blood-contacting pumps have significant complications.
• There is a need for innovative, less invasive therapeutic options for advanced heart failure.

Purpose of the Study:

• To investigate an individualized biventricular epicardial augmentation technology in a porcine model of drug-induced heart failure.
• To assess the device's impact on hemodynamics and cardiac function.
• To evaluate the feasibility of minimally invasive implantation on a beating heart.

Main Methods:

• A drug-induced porcine heart failure model was used (n=11).
• Hemodynamic and cardiac function were assessed under varying support pressures and durations.
• In vivo computer tomographic imaging was used for device positioning and function assessment.
• Minimally invasive implantation on a beating heart was performed and evaluated.

Main Results:

• Support pressures (20-80 mm Hg) improved cardiac function, increasing left ventricular stroke volume and end-systolic pressures, while decreasing end-diastolic pressures.
• Mechanical synchronization of device support with the heart's isovolumetric relaxation phase was crucial.
• A customized, self-expandable implant allowed for marker-guided, minimally invasive implantation via a 4 cm incision with fluoroscopic guidance.
• Computer tomographic imaging confirmed correct device positioning.

Conclusions:

• The individualized biventricular epicardial augmentation technology shows promise in improving cardiac function in a failing heart model.
• Minimally invasive implantation is feasible and effective.
• Further long-term survival studies are warranted to support preclinical development.