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- Title
In Vivo Testing of a Second-Generation Prototype Accessory for Single Transapical Left Ventricular Assist Device Implantation.
- Authors
Meissner, Florian; Galbas, Michelle Costa; Straky, Hendrik; Vestner, Heiko; Schoen, Manuela; Schimmel, Marius; Reuter, Johanna; Buechsel, Martin; Dinkelaker, Johannes; Cristina Schmitz, Heidi; Czerny, Martin; Bothe, Wolfgang
- Abstract
A new accessory was developed to allow implantation of left ventricular assist devices (LVADs) without requiring an anastomosis to the ascending aorta. The accessory combines the LVAD inflow and outflow into a dual-lumen device. Initial prototypes encountered reduced pump performance in vitro, but a second-generation prototype successfully addressed this issue. This feasibility study aimed to demonstrate the anatomic fit, safe implantation, and hemodynamic effectiveness of the LVAD with the accessory. The accessory was implanted in ten female pigs (104 ± 13 kg). Following sternotomy and apical coring under cardiopulmonary bypass, a balloon catheter was retrogradely inserted and exteriorized through the coring site, where it was inflated within the distal third of the outflow graft. It was utilized to pull the accessory's outflow across the aortic valve. After LVAD attachment, the catheter was removed. Echocardiography revealed no relevant valve regurgitation post-implantation. During ramp testing, pump flow increased from 3.7 ± 1.2 to 5.4 ± 1.2 L/min. Necropsy confirmed correct accessory placement in nine animals. No valve lesions or device thrombosis were observed. The accessory enabled LVAD implantation without compromising pump performance. Future work includes design refinements for implantation without cardiopulmonary bypass and long-term testing in a chronic heart failure model.
- Subjects
HEART assist devices; CARDIOPULMONARY bypass; AORTIC valve; HEART failure; PROTOTYPES
- Publication
Bioengineering (Basel), 2024, Vol 11, Issue 8, p848
- ISSN
2306-5354
- Publication type
Article
- DOI
10.3390/bioengineering11080848