PMID- 27442859
OWN - NLM
STAT- MEDLINE
DCOM- 20171106
LR  - 20181202
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 62
IP  - 6
DP  - 2016 Nov/Dec
TI  - Distinct Effects of Left or Right Atrial Cannulation on Left Ventricular 
      Hemodynamics in a Swine Model of Acute Myocardial Injury.
PG  - 671-676
AB  - Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and the TandemHeart 
      left ventricular (LV) assist device are increasingly employed as mechanical 
      circulatory support devices during acute LV injury. We examined the effects of 
      right atrial to femoral artery (RA-FA; VA-ECMO) bypass versus left atrial to 
      femoral artery (LA-FA; TandemHeart) bypass using a centrifugal pump (Cardiac 
      Assist Inc, Pittsburgh, PA) on LV hemodynamics in a swine model of acute LV 
      injury. In eight male swine, the RA-FA bypass group employed a 21 Fr inflow 
      cannula in the right atrial (RA) and a 17 Fr FA outflow cannula. The LA-FA bypass 
      group employed a 21 Fr inflow cannula in the LA and a 17 Fr FA outflow cannula. 
      Both pump configurations were activated at 3,500 rotations per minute (RPMs) 
      followed by balloon angioplasty-mediated occlusion of the left circumflex (LCx) 
      artery. After 30 minutes of LCx occlusion, RPMs through the centrifugal pump were 
      increased from 3,500, 5,500 then to a maximum at 7,500 RPMs. At 7,500 RPMs, RA-FA 
      and LA-FA bypass generated 3.5 +/- 0.1 and 3.6 +/- 0.2 liters/minute (LPM) of flow, 
      respectively. At maximum flow, RA unloading increased LV end-systolic pressure 
      and estimated wall stress, whereas LA unloading reduced LV end-diastolic 
      pressure, end-diastolic volume, and native stroke volume without changing 
      estimated wall stress. Veno-arterial extracorporeal membrane oxygenation acutely 
      increases mean arterial pressure (MAP) without unloading the LV, whereas the 
      TandemHeart maintains MAP and unloads the LV. These findings indicate that RA 
      versus LA cannulation for circulatory support have distinct acute hemodynamic 
      effects on the LV.
FAU - Esposito, Michele L
AU  - Esposito ML
AD  - From The Molecular Cardiology Research Institute and Surgical/Interventional 
      Research Laboratories, Tufts Medical Center and Tufts University School of 
      Medicine, Boston, Massachusetts.
FAU - Shah, Nimish
AU  - Shah N
FAU - Dow, Sam
AU  - Dow S
FAU - Kang, Sandra
AU  - Kang S
FAU - Paruchuri, Vikram
AU  - Paruchuri V
FAU - Karas, Richard H
AU  - Karas RH
FAU - Kapur, Navin K
AU  - Kapur NK
LA  - eng
PT  - Journal Article
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Animals
MH  - *Cardiac Catheterization
MH  - Disease Models, Animal
MH  - *Extracorporeal Membrane Oxygenation
MH  - Heart Atria
MH  - Heart Failure/*physiopathology
MH  - *Hemodynamics
MH  - Male
MH  - Swine
MH  - Ventricular Function, Left/*physiology
EDAT- 2016/11/01 06:00
MHDA- 2017/11/07 06:00
CRDT- 2016/07/22 06:00
PHST- 2016/11/01 06:00 [pubmed]
PHST- 2017/11/07 06:00 [medline]
PHST- 2016/07/22 06:00 [entrez]
AID - 10.1097/MAT.0000000000000416 [doi]
PST - ppublish
SO  - ASAIO J. 2016 Nov/Dec;62(6):671-676. doi: 10.1097/MAT.0000000000000416.