The Acute Effect of an Echo-Contrast Agent on Right Ventricular Dimensions and Contractility in Pigs

Bramos, Dimitris; Tsirikos, Nikolaos; Kottis, Giorgos; Pamboucas, Constantinos; Kostopoulou, Vichy; Trika, Crysanthi; Ikonomidis, Ignatios; Toumanidis, Savvas

doi:10.1097/fjc.0b013e31815c660c

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…21 To meet the specifications of the required intracardiac use, the PAM was customized to a 10 mm maximum width and 40 mm length which was the lower limit of a dilated human RV. 5,14 To match the typical free wall to IVS approximation distance seen during RV ejection, the required linear contraction of the PAM was determined to be 25%. 5,9,14 This contraction works against the elevated hemodynamic pressure in the RV and the afterload in the pulmonary artery.…”

Section: Methodsmentioning

confidence: 99%

“…5,14 To match the typical free wall to IVS approximation distance seen during RV ejection, the required linear contraction of the PAM was determined to be 25%. 5,9,14 This contraction works against the elevated hemodynamic pressure in the RV and the afterload in the pulmonary artery. In contrast to previously suggested PAMs for cardiac support that are actuated at pressures close to atmospheric pressure in the chest cavity, the RVED operates inside the heart.…”

Section: Methodsmentioning

confidence: 99%

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An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle

et al. 2017

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We introduce an implantable intracardiac soft robotic right ventricular ejection device (RVED) for dynamic approximation of the right ventricular (RV) free wall and the interventricular septum (IVS) in synchrony with the cardiac cycle to augment blood ejection in right heart failure (RHF). The RVED is designed for safe and effective intracardiac operation and consists of an anchoring system deployed across the IVS, an RV free wall anchor, and a pneumatic artificial muscle linear actuator that spans the RV chamber between the two anchors. Using a ventricular simulator and a custom controller, we characterized ventricular volume ejection, linear approximation against different loads and the effect of varying device actuation periods on volume ejection. The RVED was then tested in vivo in adult pigs (n = 5). First, we successfully deployed the device into the beating heart under 3D echocardiography guidance (n = 4). Next, we performed a feasibility study to evaluate the device’s ability to augment RV ejection in an experimental model of RHF (n = 1). RVED actuation augmented RV ejection during RHF; while further chronic animal studies will provide details about the efficacy of this support device. These results demonstrate successful design and implementation of the RVED and its deployment into the beating heart. This soft robotic ejection device has potential to serve as a rapidly deployable system for mechanical circulatory assistance in RHF.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle

et al. 2017

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“…Such reactions are known to occur from ultrasound contrast agents, particularly in pigs, including Definity [8], Albunex [9] and Sonovue [10]. Both Definity and Sonovue have associated warnings concerning possible human reactions.…”

Section: Methodsmentioning

confidence: 99%

“…Such reactions are known to occur from ultrasound contrast agents, particularly in pigs, including Definity, 8 Albunex (human albumin; Nycomed Imaging AS, Oslo, Norway), 9 and SonoVue. 10 Both Definity and SonoVue have associated warnings concerning possible human reactions. Pigs were given IV injections of 1 mg/kg diphenhydramine and 2 mg of dexamethasone about 1 hour before CEDUS as a preventive measure.…”

Section: Animal Preparationmentioning

confidence: 99%

Contrast-Enhanced Diagnostic Ultrasound Causes Renal Tissue Damage in a Porcine Model

Miller

Dou

Wiggins

2010

Journal of Ultrasound in Medicine

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Objective Glomerular capillary hemorrhage (GCH) has been reported and confirmed as a consequence of contrast-enhanced diagnostic ultrasound (CEDUS) of rat kidney. This study assessed renal tissue injury in the larger porcine model. Methods The right kidneys of anesthetized pigs were imaged in 8 groups of 4 pigs. A Vingmed System Five (General Electric Co. Cincinnati OH) was used at 1.5 MHz in B-mode to intermittently scan the kidney at 4 s intervals. A Sequoia 512 (Acuson, Mountain View CA) was used in the 1.5 MHz Cadence CPS mode with intermittent agent-clearance bursts at 4 s intervals. Kidneys were scanned transabdominally, or after laparotomy through a saline standoff. The Sequoia 512 probe was placed in contact with the kidney for one group. Definity (Lantheus Medical Imaging, N. Billerica, MA) was infused at 4 μl/kg/min (diluted 33:1 in saline) for 4 min during scanning. Results Blood-filled urinary tubules were evident on the kidney surface for all groups, except for the group with the probe in contact with the kidney. GCH was found by histology in 31.7 % ± 9.8 % of glomeruli in the center of the scan plane for 1.7 MPa transabdominal scanning and 1.5 % ± 2.9 % of glomeruli in sham samples (P<0.05). In addition, hematuria was detected after scanning, and tubular obstruction occurred in some nephrons. Conclusion Renal tissue damage was induced by CEDUS in the porcine model. This result, together with previous studies in rats, support an hypothesis that GCH would occur in humans from similar CEDUS.

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“…1. To minimize the acute effect of SonoVue on the function of the heart (reported in [10]), low dose (0.2 ml) of SonoVue was chosen. The reference flow values were obtained using 15μm fluorescent microspheres (Dye Trak, Triton Technology, San Diego, CA, USA) [11].…”

Section: A Experiments Setupmentioning

confidence: 99%

Quantitative myocardial perfusion analysis with contrast-enhanced ultrasound bolus tracking - preliminary animal results

Mézl

Jiřík

Matre

et al. 2013

2013 IEEE International Ultrasonics Symposium (IUS)

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This study aims at absolute quantification in ultrasound perfusion analysis in vivo. The main task of the study is to apply a perfusion model for intravascular tracers known mainly from other modalities to ultrasound perfusion analysis. Parametric formulation of the tissue residual function is proposed. Three perfusion parameters -blood flow, blood volume and mean transit time are estimated. The method is tested on preclinical data acquired from pig's heart and compared with reference blood flow values obtained using fluorescent microspheres. A fairly good match between ultrasound perfusion and the reference method was achieved.Index Terms-quantitative perfusion analysis, ultrasound contrast agent, SonoVue TM , tissue residual function, fluorescent microspheres

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The Acute Effect of an Echo-Contrast Agent on Right Ventricular Dimensions and Contractility in Pigs

Abstract: : Administration of the 2nd GUCA SonoVue is associated with an acute, transient, dose-dependent RV dilatation and an increase in pulmonary pressure with a consequent impact on RV contractility.

Cited by 6 publications

References 29 publications

An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle

An Intracardiac Soft Robotic Device for Augmentation of Blood Ejection from the Failing Right Ventricle

Contrast-Enhanced Diagnostic Ultrasound Causes Renal Tissue Damage in a Porcine Model

Quantitative myocardial perfusion analysis with contrast-enhanced ultrasound bolus tracking - preliminary animal results

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