Dynamic abdominal and thoracic aortomyoplasty in heart failure: assessment of counterpulsation

Background. Aortic counterpulsation, either biologic or mechanical, is a useful technique to support circulation during left ventricular dysfunction. Methods. In this study we used an induced cardiac failure model in acute open chest sheep to compare hemodynamic improvements between thoracic and abd...

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Veröffentlicht in:The Annals of thoracic surgery 1999-04, Vol.67 (4), p.1022-1029
Hauptverfasser: Cabrera Fischer, Edmundo I, Christen, Alejandra I, de Forteza, Eduardo, Risk, Marcelo R
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container_end_page 1029
container_issue 4
container_start_page 1022
container_title The Annals of thoracic surgery
container_volume 67
creator Cabrera Fischer, Edmundo I
Christen, Alejandra I
de Forteza, Eduardo
Risk, Marcelo R
description Background. Aortic counterpulsation, either biologic or mechanical, is a useful technique to support circulation during left ventricular dysfunction. Methods. In this study we used an induced cardiac failure model in acute open chest sheep to compare hemodynamic improvements between thoracic and abdominal aortic counterpulsation. This was achieved with left latissimus dorsi and left hemidiaphragm muscle flaps. Results. Thoracic and abdominal aortic counterpulsation in heart failure resulted in a significant improvement of hemodynamic parameters. Subendocardial viability index, defined as diastolic pressure-time index to systolic tension-time index, in thoracic and abdominal aortomyoplasty showed significant improvement (p < 0.05) when cardiac assistance was performed by electrical stimulation of each muscle flap. A new counterpulsation index derived from diastolic and systolic areas beneath the aortic pressure curve was tested, obtaining a correlation coefficient with the subendocardial viability index of 0.758 (p < 0.001). Values of subendocardial viability index and counterpulsation index showed minimal variability. Conclusions. Treatment of experimentally induced cardiac failure with dynamic abdominal aortic counterpulsation allows an effective hemodynamic improvement in open chest sheep. Furthermore, this diastolic arterial pressure augmentation could be evaluated through a new counterpulsation index derived from diastolic and systolic areas beneath the aortic pressure curve.
doi_str_mv 10.1016/S0003-4975(99)00159-9
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Aortic counterpulsation, either biologic or mechanical, is a useful technique to support circulation during left ventricular dysfunction. Methods. In this study we used an induced cardiac failure model in acute open chest sheep to compare hemodynamic improvements between thoracic and abdominal aortic counterpulsation. This was achieved with left latissimus dorsi and left hemidiaphragm muscle flaps. Results. Thoracic and abdominal aortic counterpulsation in heart failure resulted in a significant improvement of hemodynamic parameters. Subendocardial viability index, defined as diastolic pressure-time index to systolic tension-time index, in thoracic and abdominal aortomyoplasty showed significant improvement (p &lt; 0.05) when cardiac assistance was performed by electrical stimulation of each muscle flap. A new counterpulsation index derived from diastolic and systolic areas beneath the aortic pressure curve was tested, obtaining a correlation coefficient with the subendocardial viability index of 0.758 (p &lt; 0.001). Values of subendocardial viability index and counterpulsation index showed minimal variability. Conclusions. Treatment of experimentally induced cardiac failure with dynamic abdominal aortic counterpulsation allows an effective hemodynamic improvement in open chest sheep. Furthermore, this diastolic arterial pressure augmentation could be evaluated through a new counterpulsation index derived from diastolic and systolic areas beneath the aortic pressure curve.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(99)00159-9</identifier><identifier>PMID: 10320246</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animals ; Aorta, Abdominal - surgery ; Aorta, Thoracic - surgery ; Biological and medical sciences ; Counterpulsation - methods ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. 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Aortic counterpulsation, either biologic or mechanical, is a useful technique to support circulation during left ventricular dysfunction. Methods. In this study we used an induced cardiac failure model in acute open chest sheep to compare hemodynamic improvements between thoracic and abdominal aortic counterpulsation. This was achieved with left latissimus dorsi and left hemidiaphragm muscle flaps. Results. Thoracic and abdominal aortic counterpulsation in heart failure resulted in a significant improvement of hemodynamic parameters. Subendocardial viability index, defined as diastolic pressure-time index to systolic tension-time index, in thoracic and abdominal aortomyoplasty showed significant improvement (p &lt; 0.05) when cardiac assistance was performed by electrical stimulation of each muscle flap. A new counterpulsation index derived from diastolic and systolic areas beneath the aortic pressure curve was tested, obtaining a correlation coefficient with the subendocardial viability index of 0.758 (p &lt; 0.001). Values of subendocardial viability index and counterpulsation index showed minimal variability. Conclusions. Treatment of experimentally induced cardiac failure with dynamic abdominal aortic counterpulsation allows an effective hemodynamic improvement in open chest sheep. Furthermore, this diastolic arterial pressure augmentation could be evaluated through a new counterpulsation index derived from diastolic and systolic areas beneath the aortic pressure curve.</description><subject>Anesthesia. Intensive care medicine. Transfusions. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Animals</topic><topic>Aorta, Abdominal - surgery</topic><topic>Aorta, Thoracic - surgery</topic><topic>Biological and medical sciences</topic><topic>Counterpulsation - methods</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. 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Aortic counterpulsation, either biologic or mechanical, is a useful technique to support circulation during left ventricular dysfunction. Methods. In this study we used an induced cardiac failure model in acute open chest sheep to compare hemodynamic improvements between thoracic and abdominal aortic counterpulsation. This was achieved with left latissimus dorsi and left hemidiaphragm muscle flaps. Results. Thoracic and abdominal aortic counterpulsation in heart failure resulted in a significant improvement of hemodynamic parameters. Subendocardial viability index, defined as diastolic pressure-time index to systolic tension-time index, in thoracic and abdominal aortomyoplasty showed significant improvement (p &lt; 0.05) when cardiac assistance was performed by electrical stimulation of each muscle flap. A new counterpulsation index derived from diastolic and systolic areas beneath the aortic pressure curve was tested, obtaining a correlation coefficient with the subendocardial viability index of 0.758 (p &lt; 0.001). Values of subendocardial viability index and counterpulsation index showed minimal variability. Conclusions. Treatment of experimentally induced cardiac failure with dynamic abdominal aortic counterpulsation allows an effective hemodynamic improvement in open chest sheep. Furthermore, this diastolic arterial pressure augmentation could be evaluated through a new counterpulsation index derived from diastolic and systolic areas beneath the aortic pressure curve.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10320246</pmid><doi>10.1016/S0003-4975(99)00159-9</doi><tpages>8</tpages></addata></record>
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subjects Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Aorta, Abdominal - surgery
Aorta, Thoracic - surgery
Biological and medical sciences
Counterpulsation - methods
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Heart Failure - therapy
Hemodynamics
Intensive care medicine
Medical sciences
Muscle, Skeletal - transplantation
Sheep
Surgical Flaps
Tropical medicine
title Dynamic abdominal and thoracic aortomyoplasty in heart failure: assessment of counterpulsation
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