EVALUATION OF THE PULSATILITY OF A NEW PULSATILE LEFT-VENTRICULAR ASSIST DEVICE - THE INTEGRATED CARDIOASSIST CATHETER - IN DOGS

A new pulsatile left ventricle-femoral artery bypass system (integrate d cardioassist catheter system) has been developed for rapid, percutan eous insertion as a left ventricular assist device. Previous experimen ts revealed its superiority over the intraaortic balloon pump system i n maintaining the peripheral circulation and in improving myocardial b lood flow and afterload. Our objective was to determine whether the pu lsatility of left ventricular bypass of this system would be preferabl e for maintaining the peripheral circulation and managing the ischemic myocardium as compared with nonpulsatile left ventricular bypass. Ten dogs with profound heart failure were supported by this system. Their hemodynamic status and myocardial blood flow were measured under cont rol, nonpulsatile left ventricular bypass, or synchronous pulsatile le ft ventricular bypass. Significant differences between the nonpulsatil e bypass group and the pulsatile bypass group were observed in the mea n increase in aortic pressure (3.5% versus 22.2%, respectively; p < 0. 001), total cardiac output (13.0% versus 21.7%; p = 0.004), and myocar dial blood how (9.5% versus 21.8%; p < 0.001). No differences were fou nd between groups in the decrease in left atrial pressure (-20.2% vers us -20.2%; p > 0.05). The ratio of diastolic time index/tension time i ndex was shown to be improved significantly in the pulsatile bypass gr oup compared with that of control and nonpulsatile bypass groups (p < 0.001). Thus, the pulsatility of the integrated cardioassist catheter system may support the peripheral circulation and improve the myocardi al blood flow and oxygen supply/demand ratio.