LEFT VENTRICULAR BYPASS FOR MYOCARDIAL INFARCTION

Project: Research project

Project Details

Description

Our interdisciplinary group has developed a sac-type, air-driven
paracorporeal ventricular assist pump for use in patients with profound,
reversible ventricular failure after open heart operations or after
myocardial infarction and shock. The pump has been used in 13 patients
from 3 to 8 days during the 3 years. Six of these patients were discharged
from the hospital. Five are alive and well. We propose to continue to
employ this bypass pump in selected patients to determine the role of this
form of therapy. Studies will be performed to evaluate the recovery of
myocardial function and to determine the effect of bypass pumping on organ
function. Important clinical problems exist which have limited the
application and results of ventricular bypass pumping. Animal studies that
are proposed to seek solutions to these problems include left ventricular
bypass for myocardial infarction and shock, right ventricular support in
acute right ventricular failure, and development and evaluation of optimal
techniques for biventricular circulatory assistance. Certain patients with
irreversible, end-stage left ventricular failure will require a "permanent"
implantable left ventricular assist pump. The motor-driven, implantable
assist pump being developed by our group has now been employed in 5 calves
with the longest period of continuous pumping of 4 months. The two most
recent implanted pumps have each been coupled to an implantable compliance
chamber. We propose to continue the development of the implantable left
ventricular assist pump having an initial 2 year functional life. Detailed
engineering analysis will be performed to evaluate system performance and
control mechanisms. Mathematical modeling of the motor, pump, and
circulation will be continued. Flow studies will be performed using both
cine and pulsed Doppler ultrasound techniques. The motor-driven left
ventricular assist pump will be implanted in normal animals, in animals
with the mitral valve occluded, and those with profound left ventricular
failure. We will study the physiologic effects of assist pumping, the
host-prosthetic pump interaction, and the system reliability. Our goal of
this phase of the assist pump program is to complete the engineering and
physiologic testing to be ready for initial patient use at the completion
of the proposed grant period.
StatusFinished
Effective start/end date1/1/901/1/90

Funding

  • National Heart, Lung, and Blood Institute

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