Erin M. Schumer, MS, MD, Keith A. Zoeller, MEng, Paul L

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Presentation transcript:

Feasibility Study of Pulsatile Left Ventricular Assist Device for Prolonged Ex Vivo Lung Perfusion Erin M. Schumer, MS, MD, Keith A. Zoeller, MEng, Paul L. Linsky, MD, Gretel Monreal, PhD, Young Choi, BS, Guruprasad A. Giridharan, PhD, Michael A. Sobieski, CCP, RN, Mark S. Slaughter, MD, Victor H. van Berkel, MD, PhD The Annals of Thoracic Surgery Volume 99, Issue 6, Pages 1961-1968 (June 2015) DOI: 10.1016/j.athoracsur.2015.02.087 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The continuous flow (CF) or pulsatile flow (PF) ventricular assist device (VAD) circulates perfusate through the membrane oxygenator, heat exchanger, and arterial filter (Terumo Medical Corporation, Tokyo, Japan) before entering the lungs via the pulmonary artery cannula. A funneling cannula (XVIVO, Goteborg, Sweden) sewn to the left atrial cuff allows perfusate to drain into the hard shell reservoir. A gas mixture (6% oxygen, 8% carbon dioxide, and 86% nitrogen) and 100% oxygen are fed into gas/heat exchanger. The heater/cooler maintains the perfusate temperature at slight hypothermia (30°C). (PAF = pulmonary artery flow; PAP = pulmonary artery pressure; PVP = pulmonary venous pressure; VAD = ventricular assist device; X = clamp.) The Annals of Thoracic Surgery 2015 99, 1961-1968DOI: (10.1016/j.athoracsur.2015.02.087) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Overall energy equivalent pressure (EEP), (B) surplus hemodynamic energy (SHE), and (C) pulse pressure (PP) were greater for pulsatile flow ex vivo lung perfusion (EVLP) compared with continuous flow EVLP. (p < 0.05 denoted by *; data presented as mean ± standard deviation; ○ = pulsatile; ▿= continuous.) The Annals of Thoracic Surgery 2015 99, 1961-1968DOI: (10.1016/j.athoracsur.2015.02.087) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Overall pulmonary artery pressure, (B) pulmonary artery flow, and (C) input impedance were not statistically different for pulsatile flow ex vivo lung perfusion (EVLP) compared with continuous flow EVLP (p > 0.05). (* denotes individual time points when p < 0.05; data presented as mean ± standard deviation; ○ = pulsatile; ▿ = continuous.) The Annals of Thoracic Surgery 2015 99, 1961-1968DOI: (10.1016/j.athoracsur.2015.02.087) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Overall arterial partial pressure of oxygen/fraction of inspired oxygen, (B) peak airway pressure, and (C) wet to dry weight ratio are not statistically different for pulsatile flow versus continuous flow (p > 0.5). (* denotes individual time points when p < 0.05; data presented as mean ± standard deviation; ○ = pulsatile; ▿= continuous.) The Annals of Thoracic Surgery 2015 99, 1961-1968DOI: (10.1016/j.athoracsur.2015.02.087) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions