In Vitro Examination of the VentriFlo True Pulse Pump for Failing Fontan Support

The current methodology of Fontan palliation results in a one “pump” circulatory system with passive flow to the lungs. Inherent hemodynamic differences exist between a biventricular circulatory system and this modified physiology, leading to a host of long‐term complications. Mechanical circulatory...

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Veröffentlicht in:Artificial organs 2019-02, Vol.43 (2), p.181-188
Hauptverfasser: Trusty, Phillip M., Tree, Mike, Vincent, Doug, Naber, Jeffrey P., Maher, Kevin, Yoganathan, Ajit P., Deshpande, Shriprasad R.
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container_end_page 188
container_issue 2
container_start_page 181
container_title Artificial organs
container_volume 43
creator Trusty, Phillip M.
Tree, Mike
Vincent, Doug
Naber, Jeffrey P.
Maher, Kevin
Yoganathan, Ajit P.
Deshpande, Shriprasad R.
description The current methodology of Fontan palliation results in a one “pump” circulatory system with passive flow to the lungs. Inherent hemodynamic differences exist between a biventricular circulatory system and this modified physiology, leading to a host of long‐term complications. Mechanical circulatory support (MCS) is a potential option to combat these pathophysiological conditions. In this study, we examine the VentriFlo True Pulse Pump as a MCS option to support a failing Fontan patient. An in vitro circulatory loop was used to model a failing Fontan patient, reproducing pathophysiological pressures and flow rates. The VentriFlo True Pulse Pump was positioned as a right sided support, testing multiple cannulation and baffle restriction strategies, as well as various pumping parameters including flow rate, frequency, stroke volume and the ejection to filling time ratio. A 10 mm Hg decrease in IVC pressure and 0.75 L/min increase in cardiac output were achieved using a complete baffle restriction strategy. Additional cannulation and banding strategies were not as successful. Pump flow rate and frequency significantly impacted hemodynamics, while the ejection to filling time ratio did not. Though not ideal, complete baffle restriction was necessary to achieve successful support. The ability to tune individual pumping parameters for a given MCS device will have a substantial impact on the pressures and flow augmentation seen in a Fontan circulation. Both future pump design and off‐label VADs for Fontan use should consider the pump configuration and parameter combinations presented here, which offered successful support.
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subjects Banding
Cannulation
Cardiac output
Circulatory system
Complications
Computer Simulation
Congenital heart disease
Ejection
Flow velocity
Fontan
Fontan Procedure - instrumentation
Heart Defects, Congenital - surgery
Heart surgery
Heart-Assist Devices
Hemodynamics
Hemodynamics - physiology
Humans
Lungs
Mechanical circulatory support
Mercury
Models, Cardiovascular
Palliation
Parameters
Pumping
Single ventricle
Stroke
Stroke volume
Ventricular assist device
title In Vitro Examination of the VentriFlo True Pulse Pump for Failing Fontan Support
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