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| The experimental study on using of venovenous extracorporeal membrane oxygenation and atrial septostomy for right heart failure |
| Zheng Jun-bo, Wen Liang-he, Dai Qing-qing, Jiang Xue-song, Lou Shao-fei, Ye Ming, Yu Kai-jiang |
| Intensive Care Unit, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China |
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Abstract Objective To investigate the effectiveness of venovenous extracorporeal membrane oxygenation (VV-ECMO) with an atrial septostomy (AS)to treat acute right heart failure in dogs. Methods Twelve dogs were randomly divided into two groups: acute right heart failure control group (n=6) and VV-ECMO with AS treatment group (n=6).After anaesthetization, dogs underwent a thoracotomy and hemodynamic instrumentation to measure cardiac output (CO), pulmonary artery flow rate (QPA)and all relevant pressures, including left atrial pressure (LAP), pulmonary artery pressure (PAP)and mean right ventricular pressure (MRVP). Then, a baseline data set was collected. In VV-ECMO with AS treatment group, an AS was created during cardiopulmonary bypass, and the cardiopulmonary bypass circuit was converted into VV-ECMO circuit. The pulmonary artery was progressively occluded to decrease blood flow until QPA was 60%, 40%, and 0 of baseline in both groups.The above flow conditions were maintained for 30 minutes, after which data were recorded. Results The baseline hemodynamic measurements were not different between control group and treatment group (all P>0.05). CO decreased significantly at 60% and 40% QPA in control group, and significantly lower than treatment group at each flow condition (all P＜0.05). CO was not significantly different in treatment group (all P>0.05). PAP and MRVP were significantly increased in both groups at 60% and 40% QPA. LAP and MAP were significantly decreased in control group (all P＜0.05), which were not observed in treatment group. All hemodynamic measurements in treatment group were significantly superior to those in control group at 40% QPA except PAP (all P＜0.05). Conclusion VV-ECMO with AS is capable of improving hemodynamics in dogs with high-afterload induced acute right heart failure, which may serve as a novel potential treatment option for acute right heart failure patients.
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| About author:: Zheng Jun-bo, E-mail: icuzhengjunbo@126.com |
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