Copulsation Balloon for Right Ventricular Assistance

Abstract

Background-Options for management of acute right ventricular (RV) failure are limited. This report describes preliminary testing of a temporary RV assist device that acts by direct compression of the RV. The system comprises a pancake-shaped silicone balloon (5 cm diameter) connected to a drive console that delivers a 65-mL pneumatic pulse during cardiac systole. Methods and Results-Initial in vivo tests were performed on 6 pigs (weight, 41Ϯ4 kg). RV wall motion and stroke volume were monitored via transesophageal echocardiography. Acute RV failure was created by graded right coronary ligation, which yielded a 63% reduction in RV stroke volume (39.9Ϯ8.2 to 14.7Ϯ1.9 mL; PϽ0.002). We secured the balloon over the RV free wall by attaching it to the edges of the opened pericardium. The sternum was then reapproximated, and data were collected with the device off and on (every beat). Device placement had no deleterious effect on RV function. Balloon activation returned RV stroke volumes to normal (37.8Ϯ9.2 mL) and increased mean pulmonary artery pressures from 13Ϯ2 to 16Ϯ3 mm Hg (PϽ0.01). RV compression did not induce or exacerbate tricuspid regurgitation. Mean aortic pressure improved from postinfarction levels but did not return to normal. Conclusions-We conclude that the pulmonary circulation can be supported in the short term via cardiac compression and that balloon copulsation techniques for short-term RV failure should be tested in long-term models. (Circulation. 1999;99:2815-2818.)

Design and Fabrication of a Soft Robotic Direct Cardiac Compression Device

“…Previous devices in this space used simple inflatable bladders to invert the normal curvature of the heart [1][2][3][4][5][6][7][8][9]. These devices did not move with the heart or have potential to assist diastolic function.…”

“…This is advantageous because blood-contacting devices are associated with thromboembolic events, hemolysis, immune reactions and infections [1]. A number of actuation strategies for DCC have been implemented [2][3][4][5][6][7][8][9]. These actuation strategies include inflatable bladders [3][4][5][6][7][8], ionic polymer metal composites [2] and covalent shape-memory alloy fibers [8] and linear ultrasonic motors [9].…”

A New Frontier for Orthotics and Prosthetics: Application of Dielectric Elastomer Actuators to Bionics

“…Such efforts have primarily relied on pneumatic methods of supplementing heart actuation [51] . Such efforts have primarily relied on pneumatic methods of supplementing heart actuation [51] .…”

Towards Alternative Approaches for Coupling of a Soft Robotic Sleeve to the Heart

“…Previous non-biological methods to couple active devices to the epicardium include mechanical, pneumatic and chemical fixation mechanisms 7,13,[30][31][32] . Mechanical anchoring techniques include structural enclosure 13 , a saddle-like band crossing over the upper portion of the heart between the great vessels 31 , sutures through the pericardium 32 or the endocardium along the atrioventricular groove 7 , and a flexible stem that extends to the abdomen 30 . Suction can also be employed on different anatomical locations on the heart 2,15,27 .…”