Implante experimental de una bomba de asistencia circulatoria de flujo continuo en posición valvular aórtica

Abstract

IntroductionThe implanting of an axial flow pump in an aortic valve position could decrease certain complications in current pumps. It could permit an anterograde blood flow in the heart and the aorta. It could avoid the making of a bag, as well as avoiding the need for inlet and outlet cannulas, and could slow down the scar formation in the cardiac apex. ObjectiveTo study the technical feasibility of the implanting of an axial flow pump in an aortic valve position, as well as to assess the haemodynamic effects and its impact on cardiac structures. MethodsA Jarvik 2000® pump adapted for an intra-valvular implant in 7 pigs was inserted using left anterior thoracotomy and under extracorporeal circulation. The pump was fixed to the aortic ring using sutures. It assisted the subjects for an hour during an assessment was made of the haemodynamic behaviour and the cardiac structures with an epicardial echocardiogram. After euthanasia of the animal, the heart was removed for an examination of its cavities. ResultsAll the procedures were completed with the technique. With the vasoactive drugs and epicardial pacemaker support, the pump was capable of maintaining the haemodynamics of the individuals. The echocardiogram showed adequate filling of the left ventricle and good functioning of the mitral valve. The post-mortem examination showed that the coronary ostia were free and there had not been any clots in the cardiac cavities. ConclusionsIn this animal model, the implanting of an axial flow pump in an aortic valve position was possible. The pump was able to maintain the haemodynamics of the animal without significantly affecting the cardiac structures.