Ann Thorac Surg 1993;55:741-746
© 1993 The Society of Thoracic Surgeons
Pulmonary artery balloon counterpulsation: Safe after peripheral placement
George V. Letsou, MD*,a,b,
Kenneth L. Franco, MDa,b,
Wayne Detmer, BAa,b,
Spyros Condos, MSa,b,
Sidney Wolvek, MAa,b,
G.J. Walker Smith, MDa,b,
John C. Baldwin, MDa,b
a Section of Cardiothoracic Surgery and Department of Pathology, Yale University and Yale-New Haven Hospital, New Haven, Connecticut, USA
b Datascope, Inc, Oakland, New Jersey, USA
Accepted for publication July 13, 1992.
* Address reprint requests to Dr Letsou, Section of Cardiothoracic Surgery, Yale University School of Medicine, 333 Cedar St, FMB 121, New Haven, CT 06510.
Pulmonary artery balloon counterpulsation is a promising experimental technique for treatment of right ventricular failure. However, clinical application has been limited in that the only device presently available (the large-volume intraaortic balloon) must be placed within a synthetic graft. Because a balloon with a smaller volume (which could be placed through a peripheral vein and be contained entirely within the pulmonary artery) would make the technique feasible on a wider scale, we tested an 8-mL pulmonary artery balloon placed through the femoral vein in 12 dogs. Two groups of animals were compared. One group had the pulmonary artery balloon in place but not counterpulsating; the other had the pulmonary artery balloon in place and counterpulsating. Each group was studied for 12 hours. A variety of hemodynamic parameters were measured. Effective diastolic augmentation and systolic unloading were noted in all 6 dogs that underwent counterpulsation (5.0 ± 1.1 mm Hg of diastolic augmentation and 9.5 ± 1.6 mm Hg of systolic unloading). Pulmonary function, as measured by arterial blood gas sampling and pulmonary vascular resistance, was not impaired. Examination of the heart and lungs showed no detrimental pathologic effects of pulmonary artery balloon counterpulsation. Placement of the balloon through a peripheral vein with a guidewire was easy and uncomplicated. We conclude that pulmonary artery balloon counterpulsation is safe over an extended period of 12 hours in the canine model and that diastolic augmentation and systolic unloading can be produced.
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