|
CARDIOVASCULAR
|
Volume 8, 2003, No 1-2 |
A VAD in the Right Circulation of Patients with
Univentricular Hearts: An Animal Model
Y. d'Udekem d'Acoz, O. Van Caenegem, L. Jacquet, E. Legrand, D. Thiry, J.
Rubay, P. Noirhomme
Background: In the long term, patients with
univentricular hearts and high pulmonary artery pressures are doomed to either
death or heart-lung transplantation. The same fate is reserved to patients with
failing total cavo-pulmonary connections. Implantable assist devices offer a new
hope for these patients. We explored the possibility of definitive implantation
of a ventricular assist device in the pulmonary circulation of patients with
univentricular heart physiology.
Methods: Five pigs weighing a mean of 33 ± 12 kg were placed under
cardiopulmonary bypass. Univentricular hearts were obtained under cardioplegic
arrest by ligating the pulmonary artery and resecting 2 leaflets of the
tricuspid valve and the interatrial septum. A MEDOS HIA assist device was
interposed between both venae cavae and the main pulmonary artery.
Results: The animals were maintained under right ventricular assist
device for a median of 4 hours (range: 3-6 hours). Their systemic and pulmonary
artery pressures remained stable throughout the experiment. No changes were
observed on their arterial blood gases after the implantation of the device.
Conclusion: Definitive implantation of a ventricular assist device in the
right circulation of patients with univentricular hearts might become an
alternative to heart-lung transplantation in those with elevated pulmonary
artery pressures or with failing cavo-pulmonary connections. An animal model has
been developed to study this possibility.
(CVE. 2003; 8 (1/2): 109-113)
Key words: right VAD for univentricular hearts, animal model
Yves d'Udekem d'Acoz, M.D.
UCL - Cliniques Universitaires St-Luc
Avenue Hippocrate 10
B-1200 Bruxelles
Belgium
E-mail: dudekem@chir.ucl.ac.be
PABST SCIENCE PUBLISHERS
Lengerich, Berlin, Riga, Rom,
Wien, Zagreb