Implante experimental de una bomba de asistencia circulatoria en posición valvular aórtica: resultados preliminares

introduction: the implantation of an axial flow pump in aortic valve position may reduce the complications associated with long-term circulatory support. there is not currently a pump designed for this position and anatomical and hemodynamic effects of the implant are unknown. objective: to study the feasibility of implantation of an axial flow pump in aortic valve position. evaluate the hemodynamic effects and impact on cardiac structures. material and methods: adaptation of pump. design of implant in explanted fresh pig hearts. animal experiments: general anesthesia, invasive hemodynamic monitoring, ecg, o2 saturation. trans thoracic echocardiogram for reference. implantation of the pump according to previously developed technique via a left anterior thoracotomy under cardio pulmonary bypass (cpb). start of assistance and arrest of cpb. assessment of hemody-namic status and echocardiographic monitoring of ventricular function, mitral valve and pump operation. sacrifice of animals. explantation of the heart and the pump for searching thrombus. results. pig 1: implant according to the technique, but it required repair of ascending aorta. myocardial protection problems. necessity of adrenaline and pacemakers after cpb. pig 2: implant without incident. support during an hour without drugs. pig 3: implant according to the technique, but profuse bleeding in suture lines. in all cases we observed good hemodynamic stability with the assistance. eco showed good filling of the cardiac cavities and good mobility and closure of mitral valve. conclusions: in this model, implantation of an axial flow pump in aortic position was possible, it was able to maintain adequate hemodynamic without significantly affecting cardiac structures.