bioMérieux.

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This study evaluated the effectiveness of an atrial septal defect (ASD) with veno-venous extracorporeal membrane oxygenation (vvECMO) as a bridge to transplantation. Sheep (56 ± 3 kg; n = 7) underwent a right sided thoracotomy to create the ASD (diameter = 1 cm) and place instrumentation and a pulmonary artery (PA) occluder. After recovery, animals were placed on ECMO, and the PA was constricted to generate a two-fold rise in right ventricular systolic pressure. Sheep were then maintained for 60 hours on ECMO, and data were collected hourly. Five sheep survived 60 hours. One sheep died due to a circuit clot extending into the RV, and another died presumably due to an arrhythmia. Mean right ventricular pressure (mRVP) was 19±3 mmHg at baseline, averaged 27±7 mmHg over the experiment, but was not statistically significant (p = 0.27) due to one sheep without an increase. Cardiac output (CO) was 6.8±1.2 L/min at baseline, averaged 6.0±1.0 L/min during the experiment, and was statistically unchanged (p = 0.34). Average arterial oxygen saturation and pCO2 over the experiment were 96.8 ± 1.4% and 31.8 ± 3.4 mmHg, respectively. In conclusion, an ASD combined with vvECMO maintains normal systemic hemodynamics and arterial blood gases during a long-term increase in right ventricular afterload.