INVESTIGATION OF A PROTOTYPE FOR A PULSATILE MECHANICAL CIRCULATORY SUPPORT SYSTEM FOR RIGHT HEART FAILURE SITUATIONS IN A LARGE ANIMAL STUDY

Objectives: Isolated right heart failure is much rare than RHF due to left heart failure. In the last decade, treating RHF with temporary mechanical circulatory support (MSC) came into focus. MCS is an alternative to intra-aortic balloon pump (IABP) counterpulsation or surgically placed ventricular assist. Methods: This study investigates a prototype of a pulsatile, percutanous MCS in a porcine model. The MSC's membrane pump is connected to a T-splitter, which directs the blood flow either through the inlet catheter into the pump or out of the pump into the outlet catheter. A catheter in the jugular vein aspirated the blood. Bypassing the right ventricle, the blood is ejected into the pulmonary artery (PA). The pump was driven by an IABP console providing the pump rate. To simulate an RHF, the PA was obstructed by clamping. Subsequently, the MSC was activated, providing a blood flow of 3.2 L/min. The hemodynamic pressures (systolic and diastolic aortic and PA and central venous pressures) and the pump flow were measured before and after the device was activated. Results: The MSC can provide an output of 38ml per pump beat, directly proportional to the pump rate investigated from 55 bpm to 85 bpm. PA obstruction drastically worsened the hemodynamic state, which is reflected by decreasing the pressure in the aortic and PA by around 25%. When the MCS was activated, the pressures recovered up to 95% of the healthy initial conditions. The pressure in the central venous system was increased by 25% compared to the initial healthy state. After activation, the CVP recovers to health conditions. Conclusions: The data provided by this experiment show that the MCS improves the Hemodynamics in the presence of acute RV failure. More tests need to be performed to clarify the occurrence of hemolysis caused by the T-Splitter.