Abstract
We have developed an RDLVAD that improves recovery from heart failure. It consists of a valved apical conduit, an afterload-controlling chamber (ACC) and a centrifugal pump. The presence of both the apical valve and the compliant ACC can ensure full relaxation of LV. The low ACC pressure makes for a low afterload. Aim & Methods To test these effects of RDLVAD, we made an RDLVAD suitable for isolated perfused rabbit hearts. For a control group, a continuous-flow LVAD (CLVAD) was used. Twenty-seven rabbits were used. Results The working left heart model proved inappropriate for LVAD evaluation. The CLVAD produced sufficient flow even if LV failed to contract, because the mitral valve was kept open by continuous suction on the LV while LA was continuously being filled. In the isolated heart and lung preparation (Fig.), the CLVAD had a spiky, unstable pattern of pump flow and pressure, which reached −60 mL/min and −150 mmHg, respectively, indicating severely restricted LV relaxation. By contrast, in RDLVAD, the pump flow was stable and 100% higher, and max dP/dt and peak LVP decreased by 62% and 40%, respectively. Conclusion These results indicated that RDLVAD, unlike the CLVAD, did not restrict LV relaxation and greatly reduced ventricular load, and can therefore promote cardiac recovery.Figure
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