Abstract
Objective:
The capacity of the heart to maintain cardiac output can be acutely impaired as a result of myocardial infarction or other cardiac events. Medical therapy or the use of Intra-aortic Balloon Pump (IABP) may be insufficient to help the patient overcome acute cardiogenic shock. The set up of mechanical assist devices such as extracorporal membrane oxygenation (ECMO) or patient relocation into the operating room requires valuable time which is often not available. The aim of our study was to test whether a minimal-invasive left-ventricular assist device (Tandem Heart™) can be transcutaneously implanted without fluoroscopy under echocardigraphic guidance in a preclinical model.
Methods:
Three pigs (50–60kg) were subjected to transcutaneous implantation of a novel left-ventricular assist device under guidance of transesophageal echocardiography (TEE) without fluoroscopic support. The afferent cannula was inserted into the femoral vein and advanced through the inter-atrial septum into the left atrium. The efferent cannula was inserted into the contra-lateral femoral artery by Seldinger-technique, while the small centrifugal pump was placed on the upper leg of the patient, enabling a flow of 4l/min.
Results:
The advance of the efferent cannula from the inferior vena cava to the right atrium into the left atrium by septum puncture was performed under exclusive guidance of TEE.
Conclusion:
The use of the Tandem Heart™ in cases of low cardiac output syndrome on intensive care units where IABP does not suffice for treatment can be of valuable help due to simple handling and fast applicability.