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Prolonged total circulatory support using direct mechanical ventricular actuation

R A Perez-Tamayo1, M P Anstadt, R L Cothran

  • 1Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 1, 1995
PubMed
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Direct mechanical ventricular actuation (DMVA) offers cardiac assist without blood contact. This study established a sheep model for prolonged DMVA support, demonstrating its potential for long-term circulatory assistance.

Area of Science:

  • Cardiovascular Engineering
  • Medical Devices
  • Animal Models

Background:

  • Direct mechanical ventricular actuation (DMVA) is a non-blood-contacting biventricular assist method.
  • While successful in humans for over 7 days, its long-term circulatory support potential requires further investigation.
  • DMVA has not been evaluated in large ruminants, a standard preclinical model.

Purpose of the Study:

  • To develop a large animal experimental model for prolonged total circulatory support using DMVA.
  • To assess the feasibility and limitations of DMVA in a large animal model.

Main Methods:

  • Suffolk sheep (n=10) were instrumented for hemodynamic and chemistry monitoring.
  • Following instrumentation, direct mechanical ventricular actuation (DMVA) was initiated upon inducing ventricular fibrillation (VF).

Related Experiment Videos

  • Support continued until mean arterial pressure (MAP) dropped below 50% of baseline for over 1 hour, with a 7-day target.

    • Main Results:

    • Mean support duration was 65.9 ± 56.8 hours (range: 10-168 hours).
    • No pressors were required during DMVA support.
    • The longest-supported subject (7 days) was successfully defibrillated into sinus rhythm.
    • Minimal myocardial injury (CK-MB <1%) and preserved renal function (BUN, creatinine) were observed.

    Conclusions:

    • The developed sheep model represents the longest duration of DMVA support in VF.
    • This model is suitable for investigating the limitations of prolonged DMVA for circulatory support.
    • DMVA shows potential for long-term circulatory support with minimal adverse effects in this model.