Optional active compliance chamber performance in a pulmonary artery-pulmonary artery configured paracorporeal artificial lung

Scott K. Alpard, Dongfang Wang, Donald J. Deyo, Casey M. Smolarz, Sean Chambers, Joseph B. Zwischenberger

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    Introduction: Our group has developed a paracorporeal artificial lung (PAL) attached in a pulmonary artery (PA) to PA in series configuration to address profound respiratory failure and serve as a bridge to transplant and/or recovery. We recently designed, developed and converted our passive pre-PAL compliance chamber to an active, synchronized, counterpulsating assist device to relieve right heart strain and offset increased work placed on the right ventricle when the PAL is attached. In this study, we evaluated the safety and performance of both a valved and nonvalued optional active compliance chamber (OACC) in a PA-PA PAL for right heart assistance in normal adult sheep. Methods: Eleven sheep (30-50 kg) were divided into nonvalued OACC (n = 6) and valved (n = 5) OACC groups. To mimic pulmonary hypertension, a C-clamp was placed distal to the OACC-PAL and occluded until a 20% decrease in cardiac output (CO) was achieved. The OACC was activated, and right ventricular pressure (RVP), pulmonary artery pressure (PAP), mean arterial pressure (MAP) and CO were recorded. Results: All eleven animals tolerated the implantation of the OACC PAL. Activation of the OACC resulted in a significant increase in CO. Systolic and diastolic right ventricular pressure decreased in both groups. Lastly, counterpulsation increased the mean PAP in all animals and peak PAP reached 89 mmHg. Despite providing right heart assistance, synchronizing the counterpulsation was technically difficult, and the high peak PA pressures resulted in anastomotic bleeding in all animals and anastomotic breakdown in 4/11 animals. Conclusions: An OACC PAL perfused by the right ventricle applied in series with the pulmonary circulation reduces ventricular load and improves cardiac efficiency. These preliminary data suggest the potential of an artificial lung in unloading the strained right ventricle and acting as a bridge to transplantation. The augmented peak PA pressures, resulting in bleeding and anastomotic breakdown, and complexity in synchronizing the cardiac cycle with the pulsations of the augmented OACC, compromise this configuration.

    Original languageEnglish
    Pages (from-to)81-86
    Number of pages6
    JournalPerfusion
    Volume22
    Issue number2
    DOIs
    StatePublished - 2007

    Fingerprint

    chamber
    Pulmonary Artery
    Compliance
    Lung
    performance
    Pressure
    Animals
    Cardiac Output
    Counterpulsation
    animal
    Heart Ventricles
    Ventricular Pressure
    Sheep
    assistance
    Hemorrhage
    Lung Compliance
    Pulmonary Circulation
    Transplants
    Group
    Clamping devices

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

    Cite this

    Alpard, S. K., Wang, D., Deyo, D. J., Smolarz, C. M., Chambers, S., & Zwischenberger, J. B. (2007). Optional active compliance chamber performance in a pulmonary artery-pulmonary artery configured paracorporeal artificial lung. Perfusion, 22(2), 81-86. https://doi.org/10.1177/0267659107078483

    Optional active compliance chamber performance in a pulmonary artery-pulmonary artery configured paracorporeal artificial lung. / Alpard, Scott K.; Wang, Dongfang; Deyo, Donald J.; Smolarz, Casey M.; Chambers, Sean; Zwischenberger, Joseph B.

    In: Perfusion, Vol. 22, No. 2, 2007, p. 81-86.

    Research output: Contribution to journalArticle

    Alpard, Scott K. ; Wang, Dongfang ; Deyo, Donald J. ; Smolarz, Casey M. ; Chambers, Sean ; Zwischenberger, Joseph B. / Optional active compliance chamber performance in a pulmonary artery-pulmonary artery configured paracorporeal artificial lung. In: Perfusion. 2007 ; Vol. 22, No. 2. pp. 81-86.
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    abstract = "Introduction: Our group has developed a paracorporeal artificial lung (PAL) attached in a pulmonary artery (PA) to PA in series configuration to address profound respiratory failure and serve as a bridge to transplant and/or recovery. We recently designed, developed and converted our passive pre-PAL compliance chamber to an active, synchronized, counterpulsating assist device to relieve right heart strain and offset increased work placed on the right ventricle when the PAL is attached. In this study, we evaluated the safety and performance of both a valved and nonvalued optional active compliance chamber (OACC) in a PA-PA PAL for right heart assistance in normal adult sheep. Methods: Eleven sheep (30-50 kg) were divided into nonvalued OACC (n = 6) and valved (n = 5) OACC groups. To mimic pulmonary hypertension, a C-clamp was placed distal to the OACC-PAL and occluded until a 20{\%} decrease in cardiac output (CO) was achieved. The OACC was activated, and right ventricular pressure (RVP), pulmonary artery pressure (PAP), mean arterial pressure (MAP) and CO were recorded. Results: All eleven animals tolerated the implantation of the OACC PAL. Activation of the OACC resulted in a significant increase in CO. Systolic and diastolic right ventricular pressure decreased in both groups. Lastly, counterpulsation increased the mean PAP in all animals and peak PAP reached 89 mmHg. Despite providing right heart assistance, synchronizing the counterpulsation was technically difficult, and the high peak PA pressures resulted in anastomotic bleeding in all animals and anastomotic breakdown in 4/11 animals. Conclusions: An OACC PAL perfused by the right ventricle applied in series with the pulmonary circulation reduces ventricular load and improves cardiac efficiency. These preliminary data suggest the potential of an artificial lung in unloading the strained right ventricle and acting as a bridge to transplantation. The augmented peak PA pressures, resulting in bleeding and anastomotic breakdown, and complexity in synchronizing the cardiac cycle with the pulsations of the augmented OACC, compromise this configuration.",
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    AU - Chambers, Sean

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