PT264 Perventricular Pulmonary Valvotomy as a Successful Therapeutic Measure in a Case of Pulmonary Atresia With Intact Ventricular Septum and Iatrogenic Perforation of Right Ventricular Outflow Tract

Abstract

To determine whether the residual weight of a 260 g sternal accelerometer/force feedback device (AFFD) adversely affects hemodynamics during cardiopulmonary resuscitation in a piglet model of ventricular fibrillation cardiac arrest.After induction of ventricular fibrillation, cardiopulmonary resuscitation was provided to ten piglets (10.8 ± 1.9 kg) for 12 min while maintaining aortic systolic pressure of 80–90 mmHg during four 3-min periods with or without an AFFD on the chest. Cardiac output and left ventricular myocardial blood flow were determined by neutron-microsphere technique.Using a linear mixed-effect model with residual maximum likelihood estimation to control for changes in cardiopulmonary resuscitation hemodynamics over time, cardiac output and myocardial blood flow did not differ with AFFD versus without AFFD. During the first 6 min, mean (±SEM) cardiac outputs were 0.42 (±0.05) L/min with AFFD versus 0.31 (±0.04) L/min without AFFD, and median left ventricular myocardial blood flows were 40.5 (±7.3) mL/min/100 g with AFFD versus 40.4 (±5.0) mL/min/100 g without AFFD. The mean right atrial diastolic pressures and coronary perfusion pressures were also not different (8 ± 0.7 mmHg versus 8 ± 0.9 mmHg and 16 ± 2 mmHg versus 16 ± 2 mmHg, respectively, during the first 6 min of CPR).The use of a 260 g accelerometer/force feedback device designed for real-time feedback to the rescuer during resuscitation efforts did not adversely affect cardiac output or left ventricular myocardial blood flow during 12 min of chest compressions in a piglet model of ventricular fibrillation cardiac arrest.