HIGH STROKE VOLUME PARAAORTIC COUNTERPULSATION DEVICE VERSUS CENTRIFUGAL PUMP IN CARDIOGENIC-SHOCK - EXPERIMENTAL-STUDY

During the last decades a number of left ventricular assist devices ha s been used especially for patients resistant to pharmacologic treatme nt and to intraaortic balloon pump (IABP) support for left ventricular failure. A high stroke volume para-aortic counterpulsation device (PA CD) has been developed utilizing the principle of the diastolic counte rpulsation technique. In this study the hemodynamic effects of the val veless PACD were compared to those of the centrifugal blood pump (CBP) in nine dogs in acute experimental cardiogenic shock Hemodynamic meas urements were obtained at baseline with both devices off, PACD an and CBP off, or PACD off and CBP on. There was no difference in mean aorti c pressure between PACD on (60.0 +/- 11.5 mmHg) and CBP on (69.0 +/- 2 6.8 mmHg). Similarly, there was no difference in left ventricular end- diastolic pressure with the PACD on (11.9 +/- 5.4 mmHg) versus the CBP on (9.9 +/- 5.2 mmHg) or the cardiac index with the PACD on (84 +/- 3 6 ml/kg/min) versus the CBP on (77 +/- 36 ml/kg/min). However, the lef t ventricular systolic pressure (55.0 +/- 19.0 with PACD versus 73.0 /- 26.0 with CBP, p < 0.001), the tension time index (712 +/- 381 vers us 1333 +/- 694, p < 0.01), and the double product (5629 +/- 2574 vers us 7440 +/- 3294, p < 0.01) were significantly lower during assistance with the PACD than with the CBP. It was concluded that PACD is at lea st as effective as CBP for restoring hemodynamic status during acute e xperimental cardiogenic shock Moreover, the PACD unloads the left vent ricle more effectively than CBP, making it suitable for left ventricul ar mechanical support in cases with reversible myocardial damage.