In?Vivo Testing of a Novel Blood Pump for Short-Term Extracorporeal Life Support

摘要

Study DesignBioVAD DesignSurgical TechniquePostoperative Care and Data CollectionResultsCentrifugal pumps are used increasingly for temporary mechanical support for the treatment of cardiogenic shock. However, centrifugal pumps can generate excessive negative pressure and are afterload sensitive. A previously developed modified roller pump mitigates these limitations both in?vitro and in preliminary animal experiments. We report the results of intermediate-term testing of our evolving pump technology, known as the BioVAD.MethodsThe BioVAD was implanted in 6 adult male sheep (62.5 ± 3.9 kg), with drainage from the left atrium and reinfusion into the descending aorta. The sheep were monitored for 5 days. Heparin was given during the initial implantation, but no additional anticoagulants were given. Data collected included hemodynamic status, pump flow and pressures, laboratory values to monitor end-organ function and hemolysis, pathologic specimens to evaluate for thromboembolic events and organ ischemia, and explanted pump evaluation results.ResultsAll animals survived the planned experimental duration and there were no pump malfunctions. Mean BioVAD flow was 3.57 ± 0.30 L/min (57.1 mL/kg/min) and mean inlet pressure was –30.51 ± 4.25 mm Hg. Laboratory values, including plasma free hemoglobin, creatinine, lactate, and bilirubin levels, remained normal. Three animals had small renal cortical infarcts, but there were no additional thromboembolic events or other abnormalities seen on pathologic examination. No thrombus was identified in the BioVAD blood flow path.ConclusionsThe BioVAD performed well for 5 days in this animal model of temporary left ventricular assistance. Its potential advantages over centrifugal pumps may make it applicable for short-term mechanical circulatory support.CTSNet classification:27Drs Bartlett, Jahangir and Mazur disclose financial relationships with MC3 Corporation.Temporary cardiac support devices have become an important tool in the treatment of refractory cardiogenic shock. A variety of blood pumps have been used in this application, including roller, pneumatic, and now increasingly centrifugal designs. Although generally safe, there are several disadvantages to centrifugal pumps. These pumps operate at a fixed rotational speed, requiring manual adjustments to accommodate the rapid fluctuations in intravascular volume status that can be seen in critically ill patients. They are sensitive to variations in afterload, resulting in potentially undesired changes in flow [