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Vascular determinants of univentricular support
J Y Kresh1, I Izrailtyan, R J Morris
1Department of Cardiothoracic Surgery, Medical College of Pennsylvania-Hahnemann School of Medicine, Allegheny University of the Health Sciences, Philadelphia 19102, USA.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|November 6, 1998
Summary
The right heart is not essential for circulation; the left heart or a mechanical pump can suffice. Vascular properties critically regulate cardiac output and circulation maintenance.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
Background:
- The cardiovascular system relies on the interplay between cardiac pump function and vascular properties.
- Understanding the role of the right heart in maintaining circulation is crucial.
Purpose of the Study:
- To investigate the feasibility of maintaining systemic and pulmonary circulation without the right heart.
- To analyze the dynamic coupling between cardiac pump performance and vascular parameters.
Main Methods:
- Analytical modeling of the cardiovascular system, excluding neurohumoral factors.
- Experimental validation using animal models and computer simulations.
Main Results:
- Cardiac output reserve is limited by pulmonary venous pressure depletion and volume shifts.
- Near-normal flow can be sustained by managing blood volume and venous pooling.
- The left heart or a mechanical pump can support the entire circulation.
Conclusions:
- The right heart is not essential for pulmonary circulation but maintains systemic venous pressure and left heart reserve.
- Peripheral vascular parameters like stressed volume and venous capacitance are vital for self-regulating cardiac output.