Calves Chronically Implanted with a Total Artificial Heart as a Pharmacological Model

1991 ◽  
Vol 14 (12) ◽  
pp. 775-780 ◽  
Author(s):  
S.D. Everett ◽  
G.M. Pantalos ◽  
I.F. Goldenberg ◽  
J.W. Long ◽  
P.D. Robison ◽  
...  
Keyword(s):  
Vascular Resistance ◽  
Artificial Heart ◽  
Left Ventricular ◽  
Pharmacological Therapy ◽  
Total Artificial Heart ◽  
Vascular Effects ◽  
Vascular Effect ◽  
New Agents ◽  
Left Ventricular Preload ◽  
Pharmacological Model

Pharmacological therapy for congestive heart failure includes drugs that have both inotropic and vasoactive effects, although it is sometimes difficult to differentiate between the two effects. An animal with an implanted total artificial heart (TAH) allows the investigation of the vascular effect of these drugs in the absence of the effect on the myocardium. An advantage of the TAH model is its sensitivity to changes in right and left ventricular preload and afterload. Four instrumented TAH calves were given vasoactive drugs and the response was compared to control. Epinephrine, dopamine, isoproterenol, and nitroprusside were selected because of the predictability of their responses. Epinephrine caused a significant increase in systemic vascular resistance (SVR), and dopamine caused a significant increase in Pulmonary vascular resistance (PVR) and Isoproterenol caused a significant decrease in PVR. TAH implanted calves can thus serve as a pharmacological model to study the vascular response, which may be useful in investigation of new agents with inotropic and vascular effects.

Application of Adaptive Pole Assignment Method to Vascular Resistance-Based Control for Total Artificial Heart

1998 ◽  
pp. 424-427
Author(s):  
Akira Tanaka ◽  
Makoto Yoshizawa ◽  
Ken-ichi Abe ◽  
Tomoyuki Yambe ◽  
Shin-ichi Nitta
Keyword(s):  
Vascular Resistance ◽  
Artificial Heart ◽  
Pole Assignment ◽  
Total Artificial Heart ◽  
Assignment Method

Cardiovascular actions of beta-phenylethylamine

1979 ◽  
Vol 236 (4) ◽  
pp. H592-H595
Author(s):  
C. S. Liang ◽  
D. Sprecher
Keyword(s):  
Blood Pressure ◽  
Vascular Resistance ◽  
Left Ventricular ◽  
Peripheral Vascular Resistance ◽  
Adrenergic Nerve ◽  
Peripheral Vascular ◽  
Vascular Effects ◽  
Aortic Blood ◽  
Total Peripheral Vascular Resistance ◽  
Aortic Blood Pressure

beta-Phenylethylamine increased mean aortic blood pressure, total peripheral vascular resistance, left ventricular dP/dt, and (dP/dt)/P in chloralose-anesthetized dogs. Pretreatment with phentolamine reduced the increases in aortic blood pressure and total peripheral vascular resistance produced by beta-phenylethylamine, whereas, the effects of beta-phenylethylamine on left ventricular dP/dt and (dP/dt)/P were abolished by propranolol. beta-Phenylethylamine pretreatment, but increased both after phentolamine pretreatment. Furthermore, both the cardiac and vascular effects of beta-phenylethylamine were abolished by desipramine. These results indicate that beta-phenylethylamine exerts both positive inotropic and vasoconstrictory effects, probably by releasing endogenous norepinephrine from the adrenergic nerve endings.

scholarly journals The heart regulates the endocrine response to heart failure: cardiac contribution to circulating neprilysin

2017 ◽  
Vol 39 (20) ◽  
pp. 1794-1798 ◽  
Author(s):  
Mattia Arrigo ◽  
Nicolas Vodovar ◽  
Hélène Nougué ◽  
Malha Sadoune ◽  
Chris J Pemberton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Sinus ◽  
Artificial Heart ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Venous Blood ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Total Artificial Heart ◽  
Endocrine Response

Abstract Aims Heart failure (HF) is accompanied by major neuroendocrine changes including the activation of the natriuretic peptide (NP) pathway. Using the unique model of patients undergoing implantation of the CARMAT total artificial heart and investigating regional differences in soluble neprilysin (sNEP) in patients with reduced or preserved systolic function, we studied the regulation of the NP pathway in HF. Methods and results Venous blood samples from two patients undergoing replacement of the failing ventricles with a total artificial heart were collected before implantation and weekly thereafter until post-operative week 6. The ventricular removal was associated with an immediate drop in circulating NPs, a nearly total disappearance of circulating glycosylated proBNP and furin activity and a marked decrease in sNEP. From post-operative week 1 onwards, NP concentrations remained overall unchanged. In contrast, partial recoveries in glycosylated proBNP, furin activity, and sNEP were observed. Furthermore, while in patients with preserved systolic function (n = 6), sNEP concentrations in the coronary sinus and systemic vessels were similar (all P > 0.05), in patients with reduced left-ventricular systolic function, sNEP concentration, and activity were ∼three-fold higher in coronary sinus compared to systemic vessels (n = 21, all P < 0.0001), while the trans-pulmonary gradient was neutral (n = 5, P = 1.0). Conclusion The heart plays a pivotal role as a regulator of the endocrine response in systolic dysfunction, not only by directly releasing NPs but also by contributing to circulating sNEP, which in turn determines the bioavailability of other numerous vasoactive peptides.

CardioWest Total Artificial Heart in a Moribund Adolescent With Left Ventricular Thrombi

2005 ◽  
Vol 80 (4) ◽  
pp. 1490-1492 ◽  
Author(s):  
M. Cristina Smith ◽  
Francisco A. Arabía ◽  
Pei H. Tsau ◽  
Richard G. Smith ◽  
Raj K. Bose ◽  
...  
Keyword(s):  
Artificial Heart ◽  
Left Ventricular ◽  
Total Artificial Heart ◽  
Left Ventricular Thrombi

Experimental Results for Chronic Left Ventricular Assist and Total Artificial Heart Development

1983 ◽  
Vol 7 (1) ◽  
pp. 55-63 ◽  
Author(s):  
Yukihiko Nosé ◽  
Gordon Jacobs ◽  
Raymond J. Kiraly ◽  
Leonard Golding ◽  
Hiroaki Harasaki ◽  
...  
Keyword(s):  
Heart Development ◽  
Artificial Heart ◽  
Left Ventricular ◽  
Experimental Results ◽  
Total Artificial Heart ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Percutaneous Endoscopic Gastrostomy Tube in a Syncardia™ Total Artificial Heart

2016 ◽  
Vol 19 (1) ◽  
pp. 014
Author(s):  
Amit Prasad ◽  
Kai Singbartl ◽  
Jacqueline Boone ◽  
Behzad Soleimani ◽  
Mohamad Zeriouh ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Nutritional Support ◽  
Artificial Heart ◽  
Left Ventricular ◽  
Total Artificial Heart ◽  
Ventricular Assist Devices ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Left Ventricular Assist Devices ◽  
Bridge To Transplant ◽  
Endoscopic Gastrostomy

As a bridge to transplant, the Syncardia™ total artificial heart (TAH) is an option for patients who are not candidates for left ventricular assist devices (LVAD) due to right ventricular failure. The need for nutritional support in these patients is essential for a favorable outcome. Low body mass indexes and albumin levels have been associated with increased morbidity and mortality in cardiac surgery patients [Alverdy 2003]. It is not uncommon for postoperative patients to have difficulty in consuming enough calories after surgery, which is further complicated by a hypermetabolic demand due to surgical stress. Enteral nutrition has typically been favored for gut mucosal integrity and bacterial flora [Alverdy 2003] [Engleman 1999]. We describe the need for prolonged enteral nutritional support in a TAH patient that was accomplished with a percutaneous endoscopic gastrostomy (PEG) tube.

Remifentanil Induces Systemic Arterial Vasodilation in Humans with a Total Artificial Heart

2004 ◽  
Vol 100 (3) ◽  
pp. 602-607 ◽  
Author(s):  
Alexandre Ouattara ◽  
Gilles Boccara ◽  
Uwe Köckler ◽  
Patrick Lecomte ◽  
Pascal Leprince ◽  
...  
Keyword(s):  
Artificial Heart ◽  
Recovery Period ◽  
Invasive Procedure ◽  
Systemic Arterial Pressure ◽  
Early Postoperative Period ◽  
Total Artificial Heart ◽  
Right Atrial ◽  
Vascular Effects ◽  
Hemodynamic Variables ◽  
Left And Right

Background To assess intrinsic vascular effects of remifentanil, increased concentrations were infused in critically ill patients with a total artificial heart. Methods In the early postoperative period after implantation of a total artificial heart, nine ventilated patients requiring short general anesthesia were included in this study. After anesthesia was induced with 0.3 mg/kg intravenous etomidate, the artificial heart settings were modified to render cardiac output "preload-independent." While maintenance of anesthesia was ensured by a continuous infusion of etomidate, increased concentrations of remifentanil (from 0.1 to 1 microg x kg(-1) x min(-1)) were infused in steps of 5 min under hemodynamic monitoring, including left and right atrial pressures, systemic and pulmonary arterial pressures, and left and right cardiac indices. The invasive procedure was started under the highest concentration of remifentanil tolerated by the patient. Infusion of remifentanil was stopped at the end of the invasive procedure, while etomidate infusion was maintained. New hemodynamic measurements were performed at the end of the 12-min recovery period. Results Remifentanil produced a dose-dependent and significant decrease in systemic arterial pressure and vascular resistances (n = 9) from a concentration of 0.25 microg x kg(-1) x min(-1). No significant changes were observed on pulmonary vascular resistances (n = 6). Neither right (n = 9) nor left (n = 6) atrial pressures were affected by remifentanil infusion. Hemodynamic variables returned to baseline value over the 12-min recovery period. Conclusions In humans with a total artificial heart, remifentanil induces a systemic arterial vasodilation without significant effect on the capacitance vessels.

Mechanical Bridge to Transplantation with the Vienna Heart in TAH and LVAD Configuration

1992 ◽  
Vol 15 (3) ◽  
pp. 147-167 ◽  
Author(s):  
A. Moritz ◽  
A. Rokitansky ◽  
H. Schima ◽  
A. Prodinger ◽  
G. Laufer ◽  
...  
Keyword(s):  
Artificial Heart ◽  
Clinical Problem ◽  
Left Ventricular ◽  
Total Artificial Heart ◽  
Circulatory Support ◽  
Ventricular Assist ◽  
Septic Focus ◽  
Left Ventricular Assist ◽  
Liver And Kidney ◽  
Kidney Insufficiency

The Vienna heart uses a vacuum formed, pellethane pulsatile ventricle and is available in left ventricular assist (LVAD) and total artificial heart (TAH) configurations. This device was used as mechanical support of the failing heart in nine patients intended for heart transplantation. In two patients with cardiomyopathy an orthotopic TAH was implanted; one survived despite severe preoperative ischemic liver damage, and the other died of sepsis. In seven patients an atrio-aortic LVAD was implanted; six had suffered an acute myocardial infarction with cardiogenic shock, and one could not be weaned off bypass. Three patients survived. These included one 65-year-old with incipient ARDS at operation, and a 40-year-old with preoperative liver and kidney insufficiency who was transplanted in septicemia. In this patient the septic focus, natural and artificial heart, were removed at transplantation. Four patients died. In one we were unable to establish satisfactory circulation, one died after failure of the transplanted heart, one suffered a lethal cerebral embolism and one developed multi-organ failure after repeated attacks of ventricular fibrillation. With the Vienna heart sufficient circulatory support could be established with cardiac outputs between 6 and 8 l/min for the TAH and 3.5 to 4.5 I/min for the LVAD. With this type of support an overall survival rate of 44% could be achieved. Mechanical hemolysis was not a clinical problem and no device failure occurred.

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