RENAL CIRCULATION AND CELLULAR-METABOLISM DURING LEFT-VENTRICULAR ASSISTED CIRCULATION - COMPARISON STUDY OF PULSATILE AND NONPULSATILE ASSISTS

We examined left ventricular assist during 6 h for an acute myocardial infarction model in pigs. The outflow cannula was placed in the ascen ding aorta and an inflow cannula in the left atrium. A pump (Pulsatile group: Zeon Medical and Nonpulsatile group: Nikkiso HPM-15) was conne cted to each cannula. Items measured were the regional blood flow of t he cortex and the medulla in the kidney, renal arterial flow, arterial blood ketone body ratio (AKBR), lactate/pyruvic acid, BUN, creatinine and beta(2)-microglobulin. After experimental study, the kidneys were removed, and a pathological study was performed. In the pulsatile ass isted group, renal cortical blood flow increased but medulla blood flo w decreased. On the other hand, in the nonpulsatile assisted group, bo th regional blood flows decreased. That means that in the pulsatile as sisted group intrarenal redistribution improved, rather than in the no npulsatile assisted group. The results of our study indicated that pul satile assist produced superior circulation in the kidney, and the mic rocirculation on the cell level was superior as well in early treatmen t of acute left heart failure.