HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Dominique Shum-Tim Richard A. Jonas Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shum-Tim, D. Articles by Jonas, R. A. Search for Related Content PubMed PubMed Citation Articles by Shum-Tim, D. Articles by Jonas, R. A. Related Collections Related Article

Ann Thorac Surg 1997;64:1374-1380
© 1997 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Evaluation of a Pulsatile Pediatric Ventricular Assist Device in an Acute Right Heart Failure Model

Department of Cardiovascular Surgery, Children's Hospital and Harvard Medical School, Boston, Massachusetts

Background. The development of pulsatile ventricular assist devices for children has been limited mainly by size constraints. The purpose of this study was to evaluate the MEDOS trileaflet-valved, pulsatile, pediatric right ventricular assist device (stroke volume = 9 mL) in a neonatal lamb model of acute right ventricular failure.

Methods. Right ventricular failure was induced in ten 3-week-old lambs (8.6 kg) by right ventriculotomy and disruption of the tricuspid valve. Control group 1 (n = 5) had no mechanical support whereas experimental group 2 (n = 5) had right ventricular assist device support for 6 hours. The following hemodynamic parameters were measured in all animals: heart rate and right atrial, pulmonary arterial, left atrial, and systemic arterial pressures. Cardiac output was measured by an electromagnetic flow probe placed on the pulmonary artery.

Results. All results are expressed as mean ± standard deviation and analyzed by Student's t test. A p value less than 0.05 was considered statistically significant. Baseline measurements were not significantly different between groups and included systemic arterial pressure, 80.6 ± 12.7 mm Hg; right atrial pressure, 4.6 ± 1.6 mm Hg; mean pulmonary arterial pressure, 15.6 ± 4.2 mm Hg; left atrial pressure, 4.8 ± 0.8 mm Hg; and cardiac output, 1.4 ± 0.2 L/min. Right ventricular injury produced hemodynamics compatible with right ventricular failure in both groups: mean systemic arterial pressure, 38.8 ± 10.4 mm Hg; right atrial pressure, 16.8 ± 2.3 mm Hg; left atrial pressure, 1.4 ± 0.5 mm Hg; and cardiac output, 0.6 ± 0.1 L/min. All group 1 animals died at a mean of 71.4 ± 9.4 minutes after the operation. All group 2 animals survived the duration of study. Hemodynamic parameters were recorded at 2, 4, and 6 hours on and off pump, and were significantly improved at all time points: mean systemic arterial pressure, 68.0 ± 13.0 mm Hg; right atrial pressure, 8.2 ± 2.3 mm Hg; left atrial pressure, 6.4 ± 2.1 mm Hg; and cardiac output, 1.0 ± 0.2 L/min.

Conclusions. The results demonstrate the successful creation of a right ventricular failure model and its salvage by a miniaturized, pulsatile right ventricular assist device. The small size of this device makes its use possible even in small neonates.

Related Article

Discussion
Ann. Thorac. Surg. 1997 64: 1380. [Extract] [Full Text]

This article has been cited by other articles:

				A. Y. Schure, P. C. Laussen, and F. X. McGowan JR Mechanical Cardiopulmonary Support of Infants and Children With Congenital Heart Disease Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 46 - 54. [Abstract] [PDF]