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Abdominal Positioning of the Next-Generation Intra-Aortic Fluid Entrainment Pump (Aortix) Improves Cardiac Output in a Swine Model of Heart Failure.
- Source :
-
Circulation. Heart failure [Circ Heart Fail] 2018 Aug; Vol. 11 (8), pp. e005115. - Publication Year :
- 2018
-
Abstract
- Background: Acute heart failure refractory to medical therapy is a major cause of morbidity and mortality. The Aortix device (Procyrion Inc) is a percutaneously delivered entrainment pump positioned in the descending aorta.<br />Methods and Results: Using the newest generation Aortix device in 8 adult male Yorkshire swine, we tested the hypothesis that positioning in the abdominal aorta may provide superior hemodynamic effects than thoracic positioning in a swine model of postinfarct left ventricular injury.Abdominal activation generated significantly larger transaortic gradients (proximal minus distal mean aortic pressures) than thoracic positioning at all pump speeds. Compared with baseline values, activation in the abdominal, not thoracic, position significantly increased cardiac output, reduced arterial elastance, and systemic vascular resistance at low speeds. Compared with baseline values, abdominal activation also increased transpulmonary pressure gradients at medium and high speed, which was driven by trends toward higher mean pulmonary artery pressure and lower pulmonary capillary wedge pressure.<br />Conclusions: This is the first report to determine that in contrast to thoracic positioning, abdominal positioning of the newest generation Aortix device reduces left ventricular afterload and increases cardiac output at low speeds. These findings have potentially important implications for the design of early clinical studies by suggesting that device position and speed are major determinants of improved hemodynamic efficacy.
- Subjects :
- Animals
Aorta, Thoracic physiopathology
Arterial Pressure
Disease Models, Animal
Heart Failure diagnostic imaging
Heart Failure physiopathology
Male
Prosthesis Design
Recovery of Function
Sus scrofa
Time Factors
Aorta, Abdominal physiopathology
Cardiac Output
Heart Failure therapy
Heart-Assist Devices
Prosthesis Implantation methods
Ventricular Function, Left
Subjects
Details
- Language :
- English
- ISSN :
- 1941-3297
- Volume :
- 11
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Circulation. Heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 30354560
- Full Text :
- https://doi.org/10.1161/CIRCHEARTFAILURE.118.005115