MODELING OF EXTRA-AORTIC TWO-SEGMENTED COUNTERPULSATION DEVICE TO INVESTIGATE CARDIAC OUTPUT ENHANCEMENT

摘要

The intra-aortic balloon pump (IABP) has been widely used as a short-term treatment for cardiac dysfunction but has limitations and complications. Recently to overcome these limitations, intra- and extra-aortic counter pulsation devices (CPDs) have been developed. One such system, extra-aortic single cuff contains a novel implantable, nonobligatory, non-blood contacting counter pulsation heart assist device developed for minimally invasion implantation. However, this device provides insufficient cardiac output (CO) for New York Heart Association (NYHA) ambulatory class IV heart failure (HF) patients. In this paper the idea of two-segmented extra-aortic cuff has been proposed, computer simulations were performed for computational HF models to investigate the potential increase in CO using a two-segmented extra-aortic cuff. The simulation predicted increased stroke volume (SV) by 20% (9 mL), CO by 23% (0.50 L/min) diastolic coronary artery flow (CAF) by 55% (3 mL) in severe HF at a heart rate (HR) of 60 beats per minute (BPM) during counterpulsation support with two-segmented CPD. The increased efficacy of two-segmented extra-aortic CPD may provide a new treatment option for NYHA ambulatory class IV HF patients.