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Pulmonary artery balloon counterpulsation: safe after peripheral placement
G V Letsou1, K L Franco, W Detmer
1Section of Cardiothoracic Surgery, Yale University, New Haven, Connecticut.
The Annals of Thoracic Surgery
|March 1, 1993
Summary
Pulmonary artery balloon counterpulsation shows promise for treating right ventricular failure. This study found the technique safe and effective in dogs, demonstrating diastolic augmentation and systolic unloading without adverse effects.
Area of Science:
- Cardiovascular Research
- Medical Devices
- Experimental Medicine
Background:
- Right ventricular failure presents a significant clinical challenge.
- Current pulmonary artery counterpulsation devices have limitations for clinical application.
- A smaller, pulmonary artery-contained balloon could improve feasibility.
Purpose of the Study:
- To evaluate the safety and efficacy of an 8-mL pulmonary artery balloon for counterpulsation.
- To assess hemodynamic effects and potential adverse outcomes in a canine model.
- To determine feasibility of placement via peripheral venous access.
Main Methods:
- An 8-mL pulmonary artery balloon was placed via femoral vein in 12 dogs.
- Two groups: non-counterpulsating (control) and counterpulsating.
- Hemodynamic parameters, pulmonary function, and pathology were assessed over 12 hours.
Main Results:
- Successful counterpulsation achieved diastolic augmentation (5.0 ± 1.1 mm Hg) and systolic unloading (9.5 ± 1.6 mm Hg).
- No impairment in pulmonary function (arterial blood gases, pulmonary vascular resistance) was observed.
- No detrimental pathologic effects on the heart or lungs were found.
Conclusions:
- Pulmonary artery balloon counterpulsation is safe for 12-hour use in a canine model.
- The technique effectively produces diastolic augmentation and systolic unloading.
- Percutaneous placement via peripheral vein is feasible and uncomplicated.