An Extravascular Left Ventricular Assist Device

Extra-Ascending Aortic Versus Intra-Descending Aortic Balloon Counterpulsation—Effect on Coronary Artery Blood Flow

“…Long-term preclinical studies of external counterpulsation on the descending thoracic aorta using a polyurethane balloon secured with a Dacron wrap show approximately 30% medial thinning and an intact vaso vasorum and initima. 29 Medial thinning is also observed in rabbits following aortic banding, and seen in dogs with endo-aortic stents. 30,31 All these structures reduce the aortic wall strain, and apoptosis occurs, leading to thinner, denser media in the cuffed section of aorta.…”

Juxtaaortic Counterpulsation: Comparison with Intraaortic Counterpulsation in an Animal Model of Acute Heart Failure

“…16 This technique does not avoid the blood contact nor does the Kantrowitz CardioVAD device positioned in descending aorta, which has been used in humans to obtain chronic counterpulsation. 17 In our study, JABC was been found to be a simple technique that differs from the previously described by Kiso et al, 7 Zelano et al, 12 Meyns et al, 16 and Cabrera Fischer et al 13 where arterial counterpulsation was achieved by pneumatic powered devices that avoided the femoral artery route.…”

“…11 Consequently, other techniques, such as extraaortic counterpulsation, have been studied as an alternative mechanical treatment in postcardiotomy heart failure in patients with small peripheral arteries (i.e., children); arteriosclerotic or aneurysmal peripheral vessels; and diseased aortas that might be prone to obstruction, dissection, or peripheral embolization. 7,12 In 2002, we reported that JABC obtained through an extraarterial catheter balloon positioned between the ascending aorta and aortic arch and a Dacron prosthesis provided adequate circulatory support in experimental animals with induced heart failure. 8 This technique offered the advantage of avoiding the troublesome blood biomaterial interface problem.…”

“…3 In 1976, Kiso et al obtained hemodynamic improvements using an extravascular technique consisting of a flexible pneumatic pumping chamber of polyurethane encased in an ellipsoid Dacron graft wrapping the descending aorta in chronically instrumented laboratory animals. 7 In 2002, we reported a new method to obtain aortic counterpulsation in an animal model of heart failure by using a Dacron prosthesis wrapped around the ascending aorta and the aortic arch and a catheter balloon positioned between the prosthesis and the vessel. 8 This catheter balloon was positioned along the ascending aorta and aortic arch through insertion into the second intercostal space.…”

A New Approach to Assist Postoperative Heart Failure in an Animal Model: Juxta‐Aortic Counterpulsation

“…Our method differs significantly from the one previously described by Kiso and colleagues, which consisted of a balloon encased in a Dacron‐velour cloth fastened to the descending aorta in chronically instrumented animals suffering from myocardial ischemia. In our acute model of cardiac failure, we used a balloon and a manufactured prothesis wrapping the ascending aorta, containing a higher blood volume than the one contained in the descending aorta (19). Zelano and colleagues (20) in 1992 and Fischer and colleagues (12) in 1991 described avalvuled and univalvuled devices, respectively, both providing pneumatically powered juxta‐aortic counterpulsation in severe cardiac failure.…”