Direct mechanical ventricular actuation: A review

Anstadt, Mark P.; Anstadt, George L.; Lowe, James E.

doi:10.1016/0300-9572(91)90074-9

Cited by 45 publications

(9 citation statements)

References 33 publications

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“…While other DCC devices are in experimental (6–11) and clinical (12,13) use, these devices are not capable of both univentricular and BiV assists, making the results of the present study difficult to compare with others. From the present study, however, it can be concluded that BiV DCC is superior to that of LV or RV DCC alone, and that LV and RV assists contribute equally to the efficacy of BiV support.…”

Section: Discussionmentioning

confidence: 85%

Efficacy and Mechanisms of Biventricular and Left/Right Direct Cardiac Compression in Acute Heart Failure Sheep

et al. 2006

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Direct cardiac compression (DCC) with implanted heart patches has previously demonstrated efficacy of biventricular (BiV) support in acute heart failure (HF) sheep. We hypothesized that this was primarily due to a left ventricular (LV) effect. This study compared BiV, LV, and right ventricular (RV) assists in terms of hemodynamic and energetic response. Ten sheep underwent instrumentation and device implantation at least 1 week prior to study. HF (50% reduction in cardiac output) was maintained with intravenous esmolol infusion. BiV, LV, and RV assists were activated randomly with intervening stable HF periods. BiV assist was more effective than either LV or RV assist in restoring hemodynamic parameters; however, there was no difference in efficacy of LV and RV support. RV assist preserved left coronary flow patterns and chamber geometry compared to other assist conditions, but increased LV preload. These results suggest that LV and RV support each make a significant contribution to the efficacy of BiV assist, albeit through different mechanisms.

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Section: Discussionmentioning

confidence: 85%

Efficacy and Mechanisms of Biventricular and Left/Right Direct Cardiac Compression in Acute Heart Failure Sheep

et al. 2006

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“…The use of mechanical ventricular assist devices is a lifesaving procedure for heart failure patients, but this requires direct blood contact and that leads to problems such as thromboembolic events and infections. These unsolved problems provide continued focus for research and development of nonblood‐contacting circulatory support devices that could assist the heart (2).…”

Section: Discussionmentioning

confidence: 99%

An Artificial Myocardium Assist System: Electrohydraulic Ventricular Actuation Improves Myocardial Tissue Perfusion in Goats

et al. 2004

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“…11,12 These studies suggest that external forces can be safely applied to the epicardial surface of the heart to improve contractile efficiency and cardiac output. Reports published by Anstadt et al 13,14 describe a method of direct mechanical ventricular actuation (DMVA) that involves placement of a contoured cup over both ventricles. The cup is implanted through a left thoracotomy, is held in place by a slight vacuum introduced between the heart and rigid housing, and uses positive and negative pneumatic pressures to expand and deflate a flexible diaphragm that Figure 3.…”

Section: Discussionmentioning

confidence: 99%

Copulsation Balloon for Right Ventricular Assistance

1999

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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.)

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Direct mechanical ventricular actuation: A review

Cited by 45 publications

References 33 publications

Efficacy and Mechanisms of Biventricular and Left/Right Direct Cardiac Compression in Acute Heart Failure Sheep

Efficacy and Mechanisms of Biventricular and Left/Right Direct Cardiac Compression in Acute Heart Failure Sheep

An Artificial Myocardium Assist System: Electrohydraulic Ventricular Actuation Improves Myocardial Tissue Perfusion in Goats

Copulsation Balloon for Right Ventricular Assistance

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