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J Thorac Cardiovasc Surg 1999;118:924-929
© 1999 Mosby, Inc.

CARDIOPULMONARY SUPPORT AND PHYSIOLOGY

THE INTRA-AORTIC CANNULA PUMP: A NOVEL ASSIST DEVICE FOR THE ACUTELY FAILING HEART

From the Department of Cardiothoracic Surgery, Carmel Medical Center, Rappaport Institute, Faculty of Medicine, Technion-IIT, Haifa, Israel^a; and the Center for Experimental Surgery and Anaesthesiology K. U. Leuven, Belgium.^b

Address for reprints: R. Sharony, MD, Department of Cardiothoracic Surgery, Carmel Medical Center, 7, Michal St, Haifa, Israel (E-mail:sharonyr{at}tx.technion.ac.il).

Objective: The intra-aortic cannula pump is a catheter pump designed to support the acutely failing heart. It expels blood from the left ventricle into the ascending aorta in a pulsatile flow pattern. The aim of the study was to analyze the hemodynamic performance of this new intracardiac support system in acute heart failure.
Methods: A 24F cannula was studied in a series of 16 sheep. Hemodynamic changes were assessed in the nonfailing, the moderately failing, and the severely failing heart. Heart failure was induced by an injection of microspheres into the left anterior descending coronary artery. The cannula was inserted through the aortic arch and introduced through the aortic valve into the left ventricle.
Results: Cannula insertion was feasible in all animals. Flow through the intra-aortic cannula flow was increased to a maximum of 3 L/min. No hemodynamic changes were observed in the nonfailing heart. A significant increase in cardiac output was observed in the moderately and severely reduced left ventricle (2.67 ± 0.7 L to 3.51 ± 0.83 L; P = .001; and 1.18 ± 0.77 L to 2.43 ± 0.44 L; P = .001, respectively). A drop in left atrial pressure was achieved in moderate and severe heart failure (14.1 ± 5.93 mm Hg to 9.71 ± 2.63 mm Hg; P = .0001; and 23 ± 7.16 mm Hg to 11.2 ± 2.55 mm Hg; P = 0.0001, respectively). Systolic and diastolic systemic blood pressures increased in the severely failing heart (57.3 ± 12.8 mm Hg to 75.4 ± 11.2 mm Hg; P = .0001; and 35.6 ± 8.2 mm Hg to 60 ± 14.3 mm Hg; P = .0006, respectively).
Conclusions: Hemodynamic data demonstrate the beneficial effects of the intra-aortic cannula pump in moderate and severe heart failure. The intra-aortic cannula pump represents a new modality for the treatment of acute heart failure.

Presented at the Twelfth Annual Meeting of the European Association for Cardio-thoracic Surgery, Brussels, Belgium, 1998.

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