| Budget Amount *help |
¥5,800,000 (Direct Cost: ¥5,800,000)
Fiscal Year 1987: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1986: ¥4,800,000 (Direct Cost: ¥4,800,000)
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| Research Abstract |
Simultaneous drive of left ventricular assist device (LVAD) and intraaortic balloon pumping (IABP) is needed frequently but infration of intraaortic balloon affects as a resistance against counterpulsed LVAD flow and reduces renal blood flow (BF), resulted in renal dysfunction. To resolve this disadvantage, a new sequential method, Bisected Diastolic Driving (BDD) is devised. After bisecting the aortic diastole, LVAD ejects on early half of the diastole and subsequently intraaortic balloon is inflated on the remained late one, On BDD, two devices act ad counterpulsation (CP) to failing heart (FH) generating high aortic pressure (AP) with non-disturbed distribution of systemic BF, and deflation of balloon produces systolic unloading to FH. Exparimentally, decrease of renal BF and fraction on BDD was smaller then on usual combination which widely used. Two surgical cases with FH revealed impaired renal function under conventional LVAD- IABP drive up to 48 hours, but progressive improvement of renal function was observed 12 hours after BDD use. Case 1 showed s-cr 4.5 - 1.4mg/dl,BUN 60 - 38mg/dl and case 2, s-cr 3.4 - 1.4mg/dl, BUN 57 - 38mg/dl and they weaned fron LVAD within 5 days after surgery maintaining normal renal function. Determination of left ventricular function curve is very easy and accuarte method to dicise the timing of the weaning from LVAD, and inlet-outlet canula with pressure senser was devised to obtain accurate left atrial and aortic pressures from the chamber of LVAD.
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