Hemodynamic evaluation of a new left ventricular assist device: an integrated cardioassist catheter as a pulsatile left ventricle-femoral artery bypass.

Abstract

We developed a new left ventricular (LV) assist catheter (transaortic valve from LV to femoral artery) that is implemented percutaneously and exerted as a synchronous pulsatile partial LV flow support with conventional intraaortic balloon pump (IABP) driving system and centrifugal pump system. We investigated whether this pulsatile LV-aorta bypass is superior to the IABP from a hemodynamic viewpoint. Ten dogs with profound heart failure were placed on this device, and hemodynamic measurements were performed under on-off study of this system. The results revealed a significant increase of mean aortic pressure, total cardiac output, and myocardial blood flow, and a significant reduction of left atrial (LA) pressure and LV afterload estimated by diastolic pressure-time index/tension-time index (DPTI/TTI) measurement compared with baseline values and also with IABP exertion alone. These findings suggest that this system is of clinical value for supporting an impaired LV that is intractable under IABP counterpulsation.