Nonsurround, nonuniform, biventricular-capable direct cardiac compression provides Frank-Starling recruitment independent of left ventricular septal damage

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Nonsurround, nonuniform, biventricular-capable direct cardiac compression provides Frank-Starling recruitment independent of left ventricular septal damage James Mau, BSc, MBBS, Stuart Menzie, MBBS, FRACS, Yifei Huang, MD, PhD, Michael Ward, MBBS, PhD, FRACP, Stephen Hunyor, MBBS, MD, MTM, FRACP, FACC The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 1, Pages 209-215 (July 2011) DOI: 10.1016/j.jtcvs.2010.05.057 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Diagrammatic representation of HeartPatch direct cardiac compression device. Each patch was designed to conform to either the left ventricular or right ventricular contour and consisted of a thin inner and thicker outer wall. The shape and mechanical properties of the walls were designed using finite element modeling to achieve maximal inward volume displacement during inflation. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 209-215DOI: (10.1016/j.jtcvs.2010.05.057) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Load-independent hemodynamic effects of direct cardiac compression (DCC) in control and percutaneous transluminal septal myocardial ablation of the artery (PTSMA) sheep. RV PRSW, right ventricular preload recruitable stroke work; RV Ees, right ventricular end-systolic elastance; RV Tau, right ventricular diastolic relaxation constant; BiV, biventricular. (†P ≤ .01 compared with no-device value; ∗P ≤ .01, PTSMA vs control). Note: active modes of DCC increased right ventricular systolic pressure, right ventricular stroke work, and RV Ees. Compared with control group, PTSMA group had increased Ees during RV DCC and decreased PRSW during LV DCC. No significant differences seen between control and PTSMA sheep in any of remaining indexes or DCC modes. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 209-215DOI: (10.1016/j.jtcvs.2010.05.057) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 In-series hemodynamic effects of direct cardiac compression (DCC) in control and percutaneous transluminal septal myocardial ablation of the artery (PTSMA) sheep. Control group demonstrated greater right ventricular systolic pressure (RVP) during biventricular (BiV) DCC and left ventricular (LV) DCC compared with PTSMA sheep. CVP, central venous pressure; PCWP, pulmonary capillary wedge pressure; RVEF, right ventricular ejection fraction; RVCO, right ventricular cardiac output. ∗P ≤ .01, PTSMA vs control group. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 209-215DOI: (10.1016/j.jtcvs.2010.05.057) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Effect of variable modes of HeartPatch direct cardiac compression (DCC) on right ventricular (RV) stroke work (SW). RV SW during left ventricular (LV) DCC was greater in control group but was greater in PTSMA group during RV DCC. ∗P ≤ .01, PTSMA vs control. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 209-215DOI: (10.1016/j.jtcvs.2010.05.057) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions