Alteration of LV end-diastolic volume by controlling the power of the continuous-flow LVAD, so it is synchronized with cardiac beat: development of a native heart load control system (NHLCS)

作者：Umeki Akihide^*; Nishimura Takashi; Ando Masahiko; Takewa Yoshiaki; Yamazaki Kenji; Kyo Shunei; Ono Minoru; Tsukiya Tomonori; Mizuno Toshihide; Taenaka Yoshiyuki; Tatsumi Eisuke

来源：Journal of Artificial Organs, 2012, 15(2): 128-133.

DOI：10.1007/s10047-011-0615-3

• Continuous-flow LVAD
• Synchronization with cardiac beat
• End-diastolic volume
• Heart load

There are many reports comparing pulsatile and continuous-flow left ventricular assist devices (LVAD). But continuous-flow LVAD with the pulsatile driving technique had not been tried or discussed before our group%26apos;s report. We have previously developed and introduced a power-control unit for a centrifugal LVAD (EVAHEARTA (R); Sun Medical), which can change the speed of rotation so it is synchronized with the heart beat. By use of this unit we analyzed the end-diastolic volume (EDV) to determine whether it is possible to change the native heart load. We studied 5 goats with normal hearts and 5 goats with acute LV dysfunction because of micro-embolization of the coronary artery. We used 4 modes, %26quot;circuit-clamp%26quot;, %26quot;continuous%26quot;, %26quot;counter-pulse%26quot;, and %26quot;co-pulse%26quot;, with the bypass rate (BR) 100%. We raised the speed of rotation of the LVAD in the diastolic phase with the counter-pulse mode, and raised it in the systolic phase with the co-pulse mode. As a result, the EDV decreased in the counter-pulse mode and increased in the co-pulse mode, compared with the continuous mode (p %26lt; 0.05), in both the normal and acute-heart-failure models. This result means it may be possible to achieve favorable EDV and native heart load by controlling the rotation of continuous-flow LVAD, so it is synchronized with the cardiac beat. This novel driving system may be of great benefit to patients with end-stage heart failure, especially those with ischemic etiology.

• 出版日期2012-6