CHSS - Mechanical Support Of Pulmonary Blood Flow As A Strategy To Augment Systemic Cardiac Output In A Shunted Single Ventricle Circulation: Porcine Animal Model Study

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Mechanical Support Of Pulmonary Blood Flow As A Strategy To Augment Systemic Cardiac Output In A Shunted Single Ventricle Circulation: Porcine Animal Model Study
Syed M. Peer, MD, Parker Banyard, James Berry, Matt Lahti, Teri Ulferts, Satoshi Miyairi, MD, John Carney, PhD, Pranava Sinha, MD, Gurumurthy Hiremath, MD.
University of Minnesota Medical School, Minneapolis, MN, USA.

Objective: We hypothesize that mechanical assistance of pulmonary blood flow (aQp) increases systemic cardiac output (Qs) in a shunted single ventricle circulation (SSVC). Using a porcine model of a SSVC this study compared the Qs with and without aQp. Methods: A porcine model (n=4) of SSVC was created by performing atrial septostomy, tricuspid valve avulsion and placing a 6 mm systemic to pulmonary artery shunt (SPS). The unassisted SSVC was maintained for 1 hour. Using a roller pump aQp (common atrial inflow; main pulmonary artery outflow) was initiated (Flow:50-80 ml/kg/min). The assisted circulation was maintained for 1-2 hours. Paired t-test was used to compare Qs with and without aQp (Table 1).
Results: The unassisted SSVC had a mean arterial pressure (MAP) of 54 mm Hg, mean central venous pressure (CVP) of 12 mmHg and mean SPS pressure of 28 mmHg. The mean systemic blood flow (Qs) was 291 ml/min, mean SPS shunt flow (Qt) of 903 ml/min with mean Qt:Qs of 3.91. On initiation of aQp a MAP of 42 mmHg, mean CVP of 11 mmHg and mean SPS of 19 mmHg was maintained. The mean Qs increased to 587 ml/min and the mean Qt:Qs was 1.14. Conclusions: An aQp based SSVC has a significantly higher Qs compared to an unassisted SSVC. This novel strategy introduces a new paradigm in mechanical support of the SSVC.

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