Ambulatory 7-day mechanical circulatory support in sheep model of pulmonary hypertension and right heart failure.

Autor:	Ukita R; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Patel YJ; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Kelly Wu W; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Francois SA; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Cortelli M Jr; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Johnson CA Jr; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Cardwell N; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Talackine JR; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Stokes JW; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Grogan W; Auburn University, Auburn, AL, USA., Mentz M; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Tracy KM; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Harris TR; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Tucker W; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA., Simonds E; Vanderbilt University School of Medicine, Nashville, TN, USA., Demarest CT; Vanderbilt University Medical Center, Department of Thoracic Surgery, Nashville, TN, USA., Cook KE; Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, PA, USA., Skoog DJ; Advanced Respiratory Technologies Inc, Pittsburgh, PA, USA., Rosenzweig EB; Columbia University Medical Center, Department of Pediatrics, New York NY, USA., Bacchetta M; Vanderbilt University Medical Center, Department of Cardiac Surgery, Nashville, TN, USA; Vanderbilt University, Department of Biomedical Engineering, Nashville, TN, USA. Electronic address: matthew.bacchetta@vumc.org.
Jazyk:	angličtina
Zdroj:	The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2024 Feb; Vol. 43 (2), pp. 293-302. Date of Electronic Publication: 2023 Oct 29.
DOI:	10.1016/j.healun.2023.10.017
Abstrakt:	Background: Right heart failure is the major cause of death in pulmonary hypertension. Lung transplantation is the only long-term treatment option for patients who fail medical therapy. Due to the scarcity of donor lungs, there is a critical need to develop durable mechanical support for the failing right heart. A major design goal for durable support is to reduce the size and complexity of devices to facilitate ambulation. Toward this end, we sought to deploy wearable mechanical support technology in a sheep disease model of chronic right heart failure. Methods: In 6 sheep with chronic right heart failure, a mechanical support system consisting of an extracorporeal blood pump coupled with a gas exchange unit was attached in a right atrium-to-left atrium configuration for up to 7 days. Circuit performance, hematologic parameters, and animal hemodynamics were analyzed. Results: Six subjects underwent the chronic disease model for 56 to 71 days. Three of the subjects survived to the 7-day end-point for circulatory support. The circuit provided 2.8 (0.5) liter/min of flow compared to the native pulmonary blood flow of 3.5 (1.1) liter/min. The animals maintained physiologically balanced blood gas profile with a sweep flow of 1.2 (1.0) liter/min. Two animals freely ambulated while wearing the circuit. Conclusions: Our novel mechanical support system provided physiologic support for a large animal model of pulmonary hypertension with right heart failure. The small footprint of the circuit and the low sweep requirement demonstrate the feasibility of this technology to enable mobile ambulatory applications. (Copyright © 2023 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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