Autosynchronized systolic unloading during left ventricular assist with a centrifugal pump Satoshi Kono, MDa, Kazunobu Nishimura, MD, PhDa, Takeshi Nishina,

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Presentation transcript:

Autosynchronized systolic unloading during left ventricular assist with a centrifugal pump Satoshi Kono, MDa, Kazunobu Nishimura, MD, PhDa, Takeshi Nishina, MDa, Sadatoshi Yuasa, MDa, Koji Ueyama, MDa, Chikuma Hamada, PhDb, Teruaki Akamatsu, PhDc, Masashi Komeda, MD, PhDa The Journal of Thoracic and Cardiovascular Surgery Volume 125, Issue 2, Pages 353-360 (February 2003) DOI: 10.1067/mtc.2003.100 Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Schematic drawing of the experimental preparation. MSCP, Magnetically suspended centrifugal pump; CS, coronary sinus; PA, pulmonary artery; Ao, aorta; RA, right atrium; LA, left atrium; LV, left ventricle. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Rotational speed of the pump during LVAS at various assist rates. LAC, Left atrial cannulation; LVC, left ventricular cannulation; ††P <.01 compared with left atrial cannulation. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Left ventricular pressure-volume loops during LVAS at various assist rates. A, Left atrial cannulation. B, Left ventricular cannulation. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Simultaneous measurement of aortic pressure (AP), left ventricular pressure (LVP), and pump flow wave during LVAS at left atrial cannulation (LAC, top) and left ventricular cannulation (LVC, bottom) at various assist rates. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Systolic aortic pressure during LVAS at various assist rates. SAP, Systolic aortic pressure; MAP, mean aortic pressure; LAC, left atrial cannulation; LVC, left ventricular cannulation; *P <.05 compared with no assist (paired t test). Repeated-measures ANOVA: SAP cannulation: F = 4.59, P <.0608; SAP assist rate: F = 1.73, P <.1644; SAP cannulation × assist rate: F = 0.86, P <.4946. MAP cannulation: F = 0.01, P =.9445 ; MAP assist rate: F = 13.43, P <.0001; MAP cannulation × assist rate: F = 0.94, P =.4529. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 6 Left ventricular end-systolic pressure (A) and left ventricular end-diastolic pressure (B) during LVAS at various assist rates. ESP, Left ventricular end-systolic pressure; EDP, left ventricular end-diastolic pressure; LAC, left atrial cannulation; LVC, left ventricular cannulation; P <.01 compared with left atrial cannulation; *P <.05, **P <.01 compared with no assist (paired t test). Repeated-measures ANOVA: ESP cannulation: F = 77.90, P <.0001; ESP assist rate: F = 36.92, P <.0001; ESP cannulation × assist rate: F = 50.11, P <.0001. EDP cannulation: F = 2.58, P = 0.1427; EDP assist rate: F = 23.48, P <.0001; EDP cannulation × assist rate: F = 7.27, P =.0002. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 7 Left ventricular end-systolic volume (A), left ventricular end-diastolic volume (B), and left ventricular ejection fraction (C) during LVAS at various assist rates. ESV, Left ventricular end-systolic volume; EDV, left ventricular end-diastolic volume; LVEF, left ventricular ejection fraction; LAC, left atrial cannulation; LVC, left ventricular cannulation; P <.05, P <.01 compared with left atrial cannulation; *P <.05, **P <.01 compared with no assist (paired t test). Repeated-measures ANOVA: ESV cannulation: F = 12.13, P =.0069; ESV assist rate: F = 2.68, P =.0472; ESV cannulation × assist rate: F = 8.49, P <.0001; EDV cannulation: F = 1.73, P =.2208; EDV assist rate, F = 24.09, P <.0001; EDV cannulation × assist rate: F = 8.02, P <.0001; LVEF cannulation: F = 2.46, P <.1516; LVEF assist rate: F = 8.91, P <.0001; LVEF cannulation × assist rate: F = 0.75, P <.5668. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 8 External work during LVAS at various assist rates. EW, External work; LAC, left atrial cannulation; LVC, left ventricular cannulation; P <.05, P <.01 compared with left atrial cannulation; *P <.05, **P <.01 compared with no assist (paired t test). Repeated-measures ANOVA: Cannulation: F = 8.94, P =.0152; assist rate: F = 34.40, P <.0001; cannulation × assist rate: F = 2.09, P =.1029. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 9 Myocardial oxygen consumption during LVAS at various assist rates. MVO2, Myocardial oxygen consumption; LAC, left atrial cannulation; LVC, left ventricular cannulation; P <.01 compared with left atrial cannulation; *P <.05, **P <.01 compared with no assist (paired t test). Repeated-measures ANOVA: cannulation: F = 5.93, P =.0376; assist rate, F = 32.16, P <.0001; cannulation × assist rate: F = 7.88, P =.0001. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 353-360DOI: (10.1067/mtc.2003.100) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions