PMID- 28709666
OWN - NLM
STAT- MEDLINE
DCOM- 20171109
LR  - 20171109
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 104
IP  - 5
DP  - 2017 Nov
TI  - Novel Rotational Speed Modulation System Used With Venoarterial Extracorporeal 
      Membrane Oxygenation.
PG  - 1488-1495
LID - S0003-4975(17)30608-2 [pii]
LID - 10.1016/j.athoracsur.2017.04.045 [doi]
AB  - BACKGROUND: Femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is 
      widely used to maintain blood flow in patients with cardiogenic shock. However, 
      retrograde blood flow increases left ventricular (LV) afterload during femoral 
      VA-ECMO. Additional support by means of an intraaortic balloon pump (IABP) 
      alleviates LV afterload but is associated with significant adverse events. We 
      previously developed a system for rotational speed modulation in synchrony with 
      the native cardiac cycle, for use with implantable continuous-flow LV assist 
      devices. Here, we aimed to evaluate whether our novel rotation speed modulation 
      system can improve coronary artery flow and reduce LV during femoral VA-ECMO. 
      METHODS: VA-ECMO was installed by means of right atrial drainage and distal 
      abdominal aortic perfusion in six adult goats. Cardiogenic shock was induced with 
      beta-adrenergic antagonist infusion. An IABP was placed in the descending aorta. LV 
      stroke work, LV end-systolic pressure, and coronary arterial flow were evaluated. 
      Data were collected under five conditions (modes): baseline, circuit-clamp 
      (cardiogenic shock), continuous mode (constant rotational speed), counterpulse 
      mode (increasing rotational speed during diastole), and continuous mode with IABP 
      support. RESULTS: LV stroke work and LV end-systolic pressure tended to be lower 
      in the counterpulse mode, indicating decreased LV work load and afterload in this 
      mode. Furthermore, coronary arterial flow tended to be higher in the counterpulse 
      mode. CONCLUSIONS: Our system enabled an increase in coronary arterial flow and a 
      decrease in LV work load and afterload during VA-ECMO. The system offers the 
      effects of VA-ECMO and an IABP in a single device.
CI  - Copyright (c) 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Naito, Noritsugu
AU  - Naito N
AD  - Department of Cardiothoracic Surgery, Graduate School of Medicine, University of 
      Tokyo, Tokyo, Japan. Electronic address: nori.naito@gmail.com.
FAU - Nishimura, Takashi
AU  - Nishimura T
AD  - Department of Cardiac Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, 
      Japan.
FAU - Iizuka, Kei
AU  - Iizuka K
AD  - Department of Artificial Organs, National Cerebral and Cardiovascular Center, 
      Research Institute, Osaka, Japan.
FAU - Fujii, Yutaka
AU  - Fujii Y
AD  - Department of Artificial Organs, National Cerebral and Cardiovascular Center, 
      Research Institute, Osaka, Japan.
FAU - Takewa, Yoshiaki
AU  - Takewa Y
AD  - Department of Artificial Organs, National Cerebral and Cardiovascular Center, 
      Research Institute, Osaka, Japan.
FAU - Umeki, Akihide
AU  - Umeki A
AD  - Department of Cardiothoracic Surgery, Graduate School of Medicine, University of 
      Tokyo, Tokyo, Japan.
FAU - Ando, Masahiko
AU  - Ando M
AD  - Department of Cardiothoracic Surgery, Graduate School of Medicine, University of 
      Tokyo, Tokyo, Japan.
FAU - Ono, Minoru
AU  - Ono M
AD  - Department of Cardiothoracic Surgery, Graduate School of Medicine, University of 
      Tokyo, Tokyo, Japan.
FAU - Tatsumi, Eisuke
AU  - Tatsumi E
AD  - Department of Artificial Organs, National Cerebral and Cardiovascular Center, 
      Research Institute, Osaka, Japan.
LA  - eng
PT  - Journal Article
DEP - 20170712
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2018 May;105(5):1579-1580. PMID: 29685240
CIN - Ann Thorac Surg. 2018 May;105(5):1580. PMID: 29685242
MH  - Animals
MH  - Blood Flow Velocity
MH  - Combined Modality Therapy
MH  - Coronary Circulation/*physiology
MH  - Disease Models, Animal
MH  - Extracorporeal Membrane Oxygenation/*instrumentation/methods
MH  - Female
MH  - Goats
MH  - *Heart-Assist Devices
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Intra-Aortic Balloon Pumping/*methods
MH  - Random Allocation
MH  - Rotation
MH  - Sensitivity and Specificity
MH  - Shock, Cardiogenic/*therapy
MH  - Ventricular Function, Left/physiology
EDAT- 2017/07/16 06:00
MHDA- 2017/11/10 06:00
CRDT- 2017/07/16 06:00
PHST- 2016/12/06 00:00 [received]
PHST- 2017/04/01 00:00 [revised]
PHST- 2017/04/18 00:00 [accepted]
PHST- 2017/07/16 06:00 [pubmed]
PHST- 2017/11/10 06:00 [medline]
PHST- 2017/07/16 06:00 [entrez]
AID - S0003-4975(17)30608-2 [pii]
AID - 10.1016/j.athoracsur.2017.04.045 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2017 Nov;104(5):1488-1495. doi: 
      10.1016/j.athoracsur.2017.04.045. Epub 2017 Jul 12.