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 |
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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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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.</description><identifier>ISSN: 0160-564X</identifier><identifier>EISSN: 1525-1594</identifier><identifier>DOI: 10.1111/aor.13301</identifier><identifier>PMID: 30393925</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>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</subject><ispartof>Artificial organs, 2019-02, Vol.43 (2), p.181-188</ispartof><rights>2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.</rights><rights>2019 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-f3b69ceed419314e8986c67bef79f00a8ec34b17695d72a6af50f797e6020f063</citedby><cites>FETCH-LOGICAL-c3531-f3b69ceed419314e8986c67bef79f00a8ec34b17695d72a6af50f797e6020f063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faor.13301$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faor.13301$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30393925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Trusty, Phillip M.</creatorcontrib><creatorcontrib>Tree, Mike</creatorcontrib><creatorcontrib>Vincent, Doug</creatorcontrib><creatorcontrib>Naber, Jeffrey P.</creatorcontrib><creatorcontrib>Maher, Kevin</creatorcontrib><creatorcontrib>Yoganathan, Ajit P.</creatorcontrib><creatorcontrib>Deshpande, Shriprasad R.</creatorcontrib><title>In Vitro Examination of the VentriFlo True Pulse Pump for Failing Fontan Support</title><title>Artificial organs</title><addtitle>Artif Organs</addtitle><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.</description><subject>Banding</subject><subject>Cannulation</subject><subject>Cardiac output</subject><subject>Circulatory system</subject><subject>Complications</subject><subject>Computer Simulation</subject><subject>Congenital heart disease</subject><subject>Ejection</subject><subject>Flow velocity</subject><subject>Fontan</subject><subject>Fontan Procedure - instrumentation</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Heart surgery</subject><subject>Heart-Assist Devices</subject><subject>Hemodynamics</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Lungs</subject><subject>Mechanical circulatory support</subject><subject>Mercury</subject><subject>Models, Cardiovascular</subject><subject>Palliation</subject><subject>Parameters</subject><subject>Pumping</subject><subject>Single ventricle</subject><subject>Stroke</subject><subject>Stroke volume</subject><subject>Ventricular assist device</subject><issn>0160-564X</issn><issn>1525-1594</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM9LwzAUgIMobk4P_gMS8KKHbi9Nk7bHMTYdDDZ0Dm8l7RLNaJOatuj-e7sfehDM4eXwPj4eH0LXBPqkfQNhXZ9QCuQEdQnzmUdYHJyiLhAOHuPBawddVNUGAMIA-DnqUKAxjX3WRYupwStdO4vHX6LQRtTaGmwVrt8lXklTOz3JLV66RuJFk1e7WZRYWYcnQufavOGJNbUw-LkpS-vqS3SmRMtdHf8eepmMl6NHbzZ_mI6GMy-jjBJP0ZTHmZTrgMSUBDKKI57xMJUqjBWAiGRGg5SEPGbr0BdcKAbtKpQcfFDAaQ_dHbylsx-NrOqk0FUm81wYaZsq8QkFYNwnO_T2D7qxjTPtdS0V0cDnfC-8P1CZs1XlpEpKpwvhtgmBZJc5aTMn-8wte3M0Nmkh17_kT9cWGByAT53L7f-mZDh_Oii_AVlqhI8</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Trusty, Phillip M.</creator><creator>Tree, Mike</creator><creator>Vincent, Doug</creator><creator>Naber, Jeffrey P.</creator><creator>Maher, Kevin</creator><creator>Yoganathan, Ajit P.</creator><creator>Deshpande, Shriprasad R.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201902</creationdate><title>In Vitro Examination of the VentriFlo True Pulse Pump for Failing Fontan Support</title><author>Trusty, Phillip M. ; Tree, Mike ; Vincent, Doug ; Naber, Jeffrey P. ; Maher, Kevin ; Yoganathan, Ajit P. ; Deshpande, Shriprasad R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-f3b69ceed419314e8986c67bef79f00a8ec34b17695d72a6af50f797e6020f063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Banding</topic><topic>Cannulation</topic><topic>Cardiac output</topic><topic>Circulatory system</topic><topic>Complications</topic><topic>Computer Simulation</topic><topic>Congenital heart disease</topic><topic>Ejection</topic><topic>Flow velocity</topic><topic>Fontan</topic><topic>Fontan Procedure - instrumentation</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Heart surgery</topic><topic>Heart-Assist Devices</topic><topic>Hemodynamics</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Lungs</topic><topic>Mechanical circulatory support</topic><topic>Mercury</topic><topic>Models, Cardiovascular</topic><topic>Palliation</topic><topic>Parameters</topic><topic>Pumping</topic><topic>Single ventricle</topic><topic>Stroke</topic><topic>Stroke volume</topic><topic>Ventricular assist device</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Trusty, Phillip M.</creatorcontrib><creatorcontrib>Tree, Mike</creatorcontrib><creatorcontrib>Vincent, Doug</creatorcontrib><creatorcontrib>Naber, Jeffrey P.</creatorcontrib><creatorcontrib>Maher, Kevin</creatorcontrib><creatorcontrib>Yoganathan, Ajit P.</creatorcontrib><creatorcontrib>Deshpande, Shriprasad R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Artificial organs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Trusty, Phillip M.</au><au>Tree, Mike</au><au>Vincent, Doug</au><au>Naber, Jeffrey P.</au><au>Maher, Kevin</au><au>Yoganathan, Ajit P.</au><au>Deshpande, Shriprasad R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>In Vitro Examination of the VentriFlo True Pulse Pump for Failing Fontan Support</atitle><jtitle>Artificial organs</jtitle><addtitle>Artif Organs</addtitle><date>2019-02</date><risdate>2019</risdate><volume>43</volume><issue>2</issue><spage>181</spage><epage>188</epage><pages>181-188</pages><issn>0160-564X</issn><eissn>1525-1594</eissn><abstract>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.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30393925</pmid><doi>10.1111/aor.13301</doi><tpages>8</tpages></addata></record> |
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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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