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Circulatory support for right ventricular dysfunction.

G K Jett, A L Picone, R E Clark

    The Journal of Thoracic and Cardiovascular Surgery
    |July 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

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    Pulmonary artery balloon counterpulsation and right ventricular assist devices effectively treat right ventricular failure. Ventricular assist devices showed greater improvements in hemodynamic parameters compared to balloon counterpulsation.

    Area of Science:

    • Cardiovascular Surgery
    • Biomedical Engineering
    • Critical Care Medicine

    Background:

    • Right ventricular dysfunction poses a significant clinical challenge.
    • Novel circulatory support systems are emerging for managing right heart failure.
    • Surgically induced right ventricular dysfunction models are crucial for evaluating new therapies.

    Purpose of the Study:

    • To compare the efficacy of pulmonary artery balloon counterpulsation (PABC) versus a right ventricular assist device (RVAD) in a lamb model.
    • To assess the impact of these devices on hemodynamic parameters in surgically induced right ventricular dysfunction.
    • To evaluate the effectiveness of PABC and RVAD in reversing acute right heart failure.

    Main Methods:

    • Neonatal lambs underwent pulmonary artery banding for hypertrophy, followed by right ventriculotomy for dysfunction.

    Related Experiment Videos

  • Six lambs received PABC, and six received RVAD after the onset of heart failure.
  • Hemodynamic parameters including right atrial pressure, cardiac output, and aortic systolic pressure were measured during device support (on/off).

    • Main Results:

    • Both PABC and RVAD significantly decreased right atrial pressure and increased cardiac output and aortic systolic pressure.
    • RVAD demonstrated greater improvements in right atrial pressure (39% vs. 17%), cardiac output (153% vs. 54%), and aortic systolic pressure (85% vs. 39%) compared to PABC.
    • RVAD insertion, even when not operating, initially worsened right ventricular dysfunction, showing increased pressures and reduced cardiac output.

    Conclusions:

    • Both PABC and RVAD are effective in reversing surgically induced right ventricular failure.
    • RVAD offers superior hemodynamic support compared to PABC in this model.
    • Careful consideration of device-specific effects on right ventricular function is warranted during implantation.