The intra-aortic cannula pump: A novel assist device for the acutely failing heart

Sharony, Ram; Porat, Eyal E.; Nishimura, Yuichi; Meyns, Bart; Ozaki, Shigeyuki; Ràcz, Rozalia; Flameng, Willem; Uretzky, Gideon

doi:10.1016/s0022-5223(99)70063-2

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…28 Other ventricular assist devices have been adapted to provide ventricular support for beating heart procedures. A pulsatile intra-aortic cannula pump 16,29,30 and microaxial impeller pump, whose drive-motor and pump are integrated into the cannula, 31 are both capable of supporting ventricular function. These devices can be adapted for either left or right ventricular support.…”

Section: Discussionmentioning

confidence: 99%

Coronary artery bypass grafting using a miniature right ventricular support system

Toomasian¹,

Aboul‐Hosn²

2000

Perfusion

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Cardiopulmonary bypass (CPB) with cardioplegic myocardial preservation has long been the gold standard for surgical care of coronary artery disease. More recently, alternatives to the conventional approach of CPB-myocardial revascularization have been developed. Epicardial stabilizing devices have been used to immobilize areas of the beating heart to provide a stable surface for some coronary anastomoses. These approaches are often limited to anterior aspects of the heart because revascularization of posterior and lateral vessels often requires the heart to be manipulated or contorted. Excessive manipulation can lead to hemodynamic compromise as a result of partially obstructing pulmonary blood flow. A miniature extracorporeal system has been developed that uses right ventricular support and allows for epicardial surgical procedures to be conducted on a beating heart without standard CPB. The extracorporeal system consists of a coaxial atrial cannula that is connected to a miniature centrifugal pump. Blood is drained from the right atrium, passes through the miniature centrifugal pump and is delivered through the cannula's inner reinfusion lumen into the pulmonary artery. The entire circuit volume is approximately 30 ml. The system is positioned on the sterile operative field. The pump is controlled by a console positioned adjacent to the patient. The centrifugal pump is capable of delivering blood flow at rates of 1-6 l/min. This extracorporeal system may be of benefit in maintaining adequate cardiac output during epicardial beating heart surgery.

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Section: Discussionmentioning

confidence: 99%

Coronary artery bypass grafting using a miniature right ventricular support system

Toomasian¹,

Aboul‐Hosn²

2000

Perfusion

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“…Several new devices have been proposed to support the circulation during cardiogenic shock. They include the Hemopump (1), the percutaneous extracorporeal life support system (ECLS) (2), the integrated cardioassist catheter (ICAC) (3), the split‐circulation assist device (SCAD) (4), and the intra‐aortic cannula pump (IACP) (5). However, each has disadvantages.…”

mentioning

confidence: 99%

Enhanced Intra‐Aortic Balloon Pump: Markedly Improved Systemic Hemodynamics and Cardiac Function in Canines with Severe, Acute Left Ventricular Failure

Bian

Downey

2002

Artificial Organs

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Intra-aortic balloon pumps (IABPs) cannot sustain hemodynamics if the left heart is severely injured. An enhanced IABP was evaluated in 6 anesthetized dogs with acute stenosis of the left anterior descending coronary artery, regional left ventricular (LV) stunning, and global LV dysfunction. An IABP balloon was inserted into the descending aorta and an external chamber containing another IABP balloon was connected to the aorta through a catheter inserted into the left subclavian artery. This emulated the enhanced IABP with a conduit from its external chamber passing axially through an internal IABP balloon. Compared to IABP, enhanced IABP improved hemodynamics and LV function in all conditions. During severe LV dysfunction and circulatory failure, IABP failed to augment diastolic aortic pressure or improve coronary and carotid flows. Enhanced IABP augmented diastolic pressure from 32 +/- 3 mm Hg to 87 +/- 2 mm Hg and increased coronary and carotid flows. Enhanced IABP may be a lifesaving device for patients with severe LV failure.

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A Novel Miniature Ventricular Assist Device for Hemodynamic Support

Takagaki¹,

Rottenberg²,

McCarthy³

et al. 2001

ASAIO Journal

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The HemoDynamics Systems enabler is a new cardiac assist pump that can expel blood from the left ventricle and provide pulsatile flow in the aorta. We evaluated the efficacy of the 18 Fr enabler. The enabler was inserted from the left ventricular apex into the ascending aorta in eight sheep. Heart failure (mild, moderate, and severe) was induced by microsphere injection into the coronary arteries to reduce cardiac output by 10-30%, 31-50%, and more than 50% from baseline, respectively. The enabler was activated, and its flow was increased to approximately 2.0 L/min. Hemodynamic variables were recorded before and after activation. In moderate heart failure, cardiac output and mean aortic pressure increased from 2.3 +/- 0.6 L/min and 59 +/- 12 mm Hg before assist to 2.8 +/- 0.6 L/min and 70 +/- 8 mm Hg at 30 minutes after activation, respectively (p < 0.01). Left atrial pressure decreased from 17 +/- 3 to 13 +/- 4 mm Hg (p < 0.05). Similar findings were observed in mild and severe heart failure. Despite its small diameter, the enabler significantly improved the hemodynamics of failing hearts and may potentially serve as a means of peripheral left ventricular support. Further study is warranted.

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The intra-aortic cannula pump: A novel assist device for the acutely failing heart

Abstract: Hemodynamic data demonstrate the beneficial effects of the intra-aortic cannula pump in moderate and severe heart failure. The intra-aortic cannula pump represents a new modality for the treatment of acute heart failure.

Cited by 4 publications

References 22 publications

Coronary artery bypass grafting using a miniature right ventricular support system

Coronary artery bypass grafting using a miniature right ventricular support system

Enhanced Intra‐Aortic Balloon Pump: Markedly Improved Systemic Hemodynamics and Cardiac Function in Canines with Severe, Acute Left Ventricular Failure

A Novel Miniature Ventricular Assist Device for Hemodynamic Support

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