Mechanical unloading with a miniature in-line axial flow pump as an alternative to cardiopulmonary bypass

Joseph DeRose, Juan P. Umana, John D. Madigan, John F. Klinger, Robert K. Jarvik, Benjamin C. Sun, Eric A. Rose, Mehmet C. Oz

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Cardiopulmonary bypass (CPB) causes a well described systemic inflammatory response. To avoid these potential detrimental effects, coronary artery bypass grafting (CABG) has been attempted off CPB on the beating heart. With the use of a left ventricular (LV) assist device during CABG, the heart can be made flaccid with β-blockade, and the systemic circulation can continue to be supported. The hemodynamic and hematologic consequences of left heart bypass with a miniature axial flow pump were studied in a sheep CABG model. The pump weighs 45 g and was connected to standard venous and arterial cannulas. Left sided inflow and brachiocephalic outflow were employed. A pump speed of 14,000 rpm resulted in a flow of 5.63 ± 0.18 L/min and provided 75 % of the LV output during a 2 hr pump run. This resulted in complete capture of the aortic pressure tracing (mean 56.3 mmHg) with a 15.5 mmHg augmentation in the esmolol depressed ventricle. Reductions in LV end diastolic pressure and LV end systolic pressure resulted in a 66% reduction in LV external work under baseline conditions and an 83% reduction in the β- blocked ventricle. Myocardial oxygen demand was reduced 16% after axial flow unloading in the esmolol depressed condition. Right ventricular pressures, pulmonary artery flow, LV filling, and oxygenation were adequate in the esmolol depressed animal and remained unchanged throughout the experiment. No changes in hematocrit, total bilirubin, lactate dehydrogenase, or plasma free hemoglobin were detected after 2 hr of assist. Axial flow left heart bypass results in acceptable hemodynamics with no hemolysis and may provide an alternative to CPB during CABG.

Original languageEnglish (US)
JournalASAIO Journal
Volume43
Issue number5
StatePublished - Sep 1997
Externally publishedYes

Fingerprint

Axial flow
Unloading
Cardiopulmonary Bypass
Coronary Artery Bypass
Left Heart Bypass
Pumps
Hemodynamics
Left ventricular assist devices
Blood Pressure
Heart-Assist Devices
Oxygenation
Hemoglobin
Ventricular Pressure
Hemolysis
Hematocrit
L-Lactate Dehydrogenase
Bilirubin
Pulmonary Artery
Sheep
Arterial Pressure

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering

Cite this

DeRose, J., Umana, J. P., Madigan, J. D., Klinger, J. F., Jarvik, R. K., Sun, B. C., ... Oz, M. C. (1997). Mechanical unloading with a miniature in-line axial flow pump as an alternative to cardiopulmonary bypass. ASAIO Journal, 43(5).

Mechanical unloading with a miniature in-line axial flow pump as an alternative to cardiopulmonary bypass. / DeRose, Joseph; Umana, Juan P.; Madigan, John D.; Klinger, John F.; Jarvik, Robert K.; Sun, Benjamin C.; Rose, Eric A.; Oz, Mehmet C.

In: ASAIO Journal, Vol. 43, No. 5, 09.1997.

Research output: Contribution to journalArticle

DeRose, J, Umana, JP, Madigan, JD, Klinger, JF, Jarvik, RK, Sun, BC, Rose, EA & Oz, MC 1997, 'Mechanical unloading with a miniature in-line axial flow pump as an alternative to cardiopulmonary bypass', ASAIO Journal, vol. 43, no. 5.
DeRose, Joseph ; Umana, Juan P. ; Madigan, John D. ; Klinger, John F. ; Jarvik, Robert K. ; Sun, Benjamin C. ; Rose, Eric A. ; Oz, Mehmet C. / Mechanical unloading with a miniature in-line axial flow pump as an alternative to cardiopulmonary bypass. In: ASAIO Journal. 1997 ; Vol. 43, No. 5.
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