PREDICTED HEMODYNAMIC BENEFITS OF COUNTERPULSATION THERAPY USING A SUPERFICIAL SURGICAL APPROACH

Abstract

A volume-displacement counterpulsation device (CPD) intended for chronic implantation via a superficial surgical approach is proposed. The CPD is a pneumatically driven sac that fills during native heart systole and empties during diastole through a single, valveless cannula anastomosed to the subclavian artery. Computer simulation was performed to predict and compare the physiological responses of the CPD to the intra-aortic balloon pump (IABP) in a clinically-relevant model of early stage heart failure. The effect of device stroke volume (0–50 ml) and control modes (timing, duration, morphology) on landmark hemodynamic parameters and the left ventricular pressure-volume relationship were investigated. Simulation results predicted that the CPD would provide hemodynamic benefits comparable to an IABP as evidenced by up to 25% augmentation of peak diastolic aortic pressure which increases diastolic coronary perfusion by up to 34%. The CPD may also provide up to 34% reduction in left ventricular end diastolic pressure and 12% reduction in peak systolic aortic pressure lowering left ventricular workload by up to 26% and increasing cardiac output by up to 10%. This study demonstrated that the superficial CPD technique may be used acutely to achieve similar improvements in hemodynamic function as the IABP in early stage heart failure patients.