The Annals of Thoracic Surgery, Vol 21, 209-214, Copyright © 1976 by The Society of Thoracic Surgeons
Production of controlled reversible left ventricular failure in calves using intracoronary lidocaine hydrochloride: a useful method of evaluating left ventricular assist devices
CJ Carlos, CH Edmonds, JM Fuqua, CW Hibbs, SR Igo, S Nitta and JC Norman
The experimental production of stable, controlled, short-term left
ventricular failure is valuable in the evaluation of implantable
circulatory support systems. Acute or chronic left ventricular failure
produced by occlusion or embolization of coronary arteries results in
muscle dysfunction and degrees of failure that may be difficult to control.
The effects of varying amounts of intracoronary lidocaine were studied
during short- and long-term evaluations of intracorporeal left ventricular
assist pumping. In 8 Hereford calves the left main coronary artery was
cannulated with an intracoronary catheter in open and closed chest
preparations. Dose-related negative inotropic effects were noted when
lidocaine was injected at individual doses of 50, 75, and 100 mg. Following
100 mg doses, mean aortic pressure, cardiac output, and maximum rate of
rise of left ventricular pressure decreased; left ventricular end-diastolic
pressure increased fourfold. Similar effects were noted with short
continuous infusions of lidocaine. The initial responses to injection or
continuous infusions, if effective, were noted within 40 to 60 seconds.
Several episodes of failure could be produced with either method following
recovery periods of 10 to 15 minutes. In all instances, actuation of a left
ventricular assist device immediately reversed the hemodynamic effects of
the pharmacologically induced failure.
