Mechanical circulatory support via the left ventricular vent: the concept of left ventricular copulsation

Left ventricular copulsation was evaluated as a means of circulatory support in an experimental canine cardiogenic shock preparation. Copulsation was effected by a commercially available pulsatile assist device which was attached to an apical left ventricular vent cannula. The hemodynamic effects were compared with those of intra-aortic balloon pumping (IABP) in the same animals. Copulsation produced a 35.6% increase in mean aortic blood pressure, a 32.3% reduction in mean left atrial pressure, a 66.7% increase in cardiac output, and a 76.2% increase in coronary blood flow. The improvement in these variables was significantly greater during left ventricular copulsation than during IABP (p less than 0.05). The method is simple, uses equipment that is readily available, and is potentially a powerful intermediate circulatory support modality between IABP and more complex techniques.