Juxtaaortic counterpulsation: comparison with intraaortic counterpulsation in an animal model of acute heart failure.
ABSTRACT This study was designed to compare the effects of juxtaaortic balloon counterpulsation (JABC), performed in ascending aorta and the aortic arch, with those yielded by intraaortic balloon counterpulsation (IABC) in descending aorta, in experimental animals during induced cardiac failure. JABC was achieved with a manufactured Dacron prosthesis and a balloon pump placed between the prosthesis and the wrapped aorta. JABC resulted in a significant increase of cardiac output (from 2.33+/-0.82 to 2.61+/-1.12 L/min, p < 0.05), cardiac index (from 0.071+/-0.025 to 0.080+/-0.033 L/min/kg, p < 0.05) and diastolic pressure augmentation evaluated through diastolic and systolic areas beneath the aortic pressure curve (DABAC/SABAC) index (from 0.94+/-0.21 to 1.10+/-0.33, p < 0.01). End diastolic aortic pressure showed a significant decrease with JABC (from 31.90+/-7.09 to 27.83+/-9.72 mm Hg, p < 0.05). A close association between percentage of DABAC/SABAC increases obtained with IABC and JABC was observed (r2 = 0.67; p < 0.001). Counterpulsation obtained by a juxtaaortic catheter placed in the arch and the ascending wrapped aorta results in an effective hemodynamic improvement comparable with that achieved by an intraaortic catheter in open chest sheep.
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ABSTRACT: While the effects of increases in forward blood flow on the arterial diameter and elasticity are known, the effects of reversal flow on the arterial properties remain to be characterized. The intra-aortic balloon pumping (IABP), the device most frequently used in circulatory support, acts generating changes in aortic flow (i.e. increasing reversal flow). Recently, in vitro studies showed that flow reversion reduces the endothelial release of relaxing factors. Hence, vascular smooth muscle (VSM) dependent changes in the aortic properties would be expected during IABP. The aim was to analyze the changes in flow during IABP and to characterize the potential effects of reversal blood flow on the aortic biomechanics. Pressure, flow and diameter were measured in sheep, before and during IABP circulatory support. Potential effects of IABP-dependent high reversal flow conditions on viscous and elastic aortic modulus were analyzed, using isobaric analysis. Flow and pressure waveforms were analyzed in the time domain, and the contribution of oscillatory forward and backward waves to the IABP-dependent changes in flow patterns were evaluated. We found that IABP changed mainly diastolic blood flow, with an increase in the reversal flow, secondary to an increase in the oscillatory backward wave amplitude. The acute increase in reversal flow during IABP was associated with vasoconstriction and changes in the aortic mechanics, possibly due to VSM activation.Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2007; 2007:3986-9. DOI:10.1109/IEMBS.2007.4353207
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ABSTRACT: The intraaortic balloon pump (IABP) is the single most effective and widely used device for temporary mechanical assistance of the failing heart. Although the principles underlying IABP function are simple, various biologic factors often determine its performance in a particularly complicated way. We briefly describe the basic disciplines of counterpulsation by IABP and the induced hemodynamic changes while clarifying the biologic mechanisms that play a crucial role in the modification of IABP acute hemodynamic performance.ASAIO Journal 05/2005; 51(3):296-300. DOI:10.1097/01.MAT.0000159381.97773.9B · 1.39 Impact Factor
- 01/2005; XXVI(2):0-.