Pulsatile Venoarterial Perfusion Using a Novel Synchronized Cardiac Assist Device Augments Coronary Artery Blood Flow During XXXX .

@entity1 @entity1707 @entity12526 @entity2224 @entity1167 @entity1455
UNASSIGNED: @entity1 with @entity1455 have a very high mortality. Here we report the first use of a percutaneous pulsatile cardiac assist device, based on a diagonal pump synchronized with the heart cycle by means of an electrocardiographic signal in adult @entity1707 . Eight @entity12526 underwent mandatory ventilation. During sinus rhythm, there were no differences between pulsatile and nonpulsatile perfusion with regard to pulmonary artery pressure, pulmonary wedge pressure, central venous pressure, mean arterial pressure (MAP), mean pulse pressure, and mean coronary artery flow (CAF). After 2   min of complete @entity1167 ( @entity2224 ), circulatory support with the i-cor in venoarterial nonpulsatile extracorporeal membrane oxygenation (ECMO) mode (3   L/min) restored systemic circulation, with an increase of MAP to 78.3   mm   Hg and CAF to 5.27   mL/min. After changing from ECMO settings to pulsatile mode (3   L/min, 75   bpm, pulse amplitude range 3500   rpm), MAP did not change significantly (75.6   mm   Hg); however, CAF increased to 8.45   mL/min. After changing back to nonpulsatile mode, MAP remained stable (83.6   mm   Hg), but CAF decreased to 4.85   mL/min. Thereafter, pulsatile cardiac assist was established with a reduced blood flow of 2.5   L/min, and the pulse amplitude range was extended to 4500 rpm. Under these conditions, MAP remained stable (71.0   mm   Hg), but CAF significantly increased to 15.2   mL/min (P   <   0.05). Percutaneous cardiac support using a venoarterial cardiac assist device equipped with a novel diagonal pump is able to restore and increase systemic and coronary circulation during @entity2224 . Electrocardiographically triggered synchronized cardiac assist provides an additional increase of coronary artery flow. These promising results are to be confirmed in @entity1 .
