1989 Fiscal Year Final Research Report Summary
A new bridging technique to heart transplantation (Tx)-Feasibility of monoventricularization (Monovent) of bilateral ventricles with LVAD
| Project/Area Number |
63480322
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Thoracic surgery
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| Research Institution | Keio University |
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Principal Investigator |
YOZU Ryohei KEIO Univ, Sch. of Medicine staff Surgeon, 医学部, 助手 (30129738)
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| Co-Investigator(Kenkyū-buntansha) |
KUROSAKA Yuh same as above resident, 医学部, 助手 (00186537)
SOMA Yasuhiro same as above Assistant Prof., 医学部, 講師 (40051437)
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| Project Period (FY) |
1988 – 1989
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| Keywords | Ventricular assist device / Acute myocardial infarction / Ventriculdr Septal Perforation / Mono-ventricularization / Mitral valve insufficiency / Heart Transplantation / Artificial Organs / Bridge USE of Artificial heart |
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| Research Abstract |
Since the prognosis of VSP and MR after acute MI was remarkably poor, heart transplantation would be necessary for many of those patients. A new bridging technique was examined in canine modles. The bilateral ventricles communicating through VSP were monoventricularized with mitral valve closure and maintained the pulmonary circulation which had low vascular resistance. The systemic circulation was maintained by a LVAD placed between the left atriumand the aorta.
VSP and MR were made in eight mongrel dogs (pulmonary to systemic flow ratio=2.24<plus-minus>0.90). Then they were monoventricularized and equipped with LVAD. The hemodynamic state was evaluated A) in intact hearts, B) after VSP and MR were made and C) after monoventricularization and assisted circulation by LVA
Cardiac output was A) 90.60<plus-minus>23.16, B) 42.23<plus-minus>15.76 and C) 73.43<plus-minus>15.14 ml/kg/min(A vs C:NS, A vs B and B vs C:p<0.01); mean aortic pressure was A) 96.75([SY.+-.[)24.69, B) 30.25([SY.+-.[)11.08 and C) 66.50<plus-minus>18.40 mm Hg (A vs B:p<0.01, A vs C and B vs C:p<0.05); central venous pressure was A)4.76<plus-minus>1.68, B) 8.94<plus-minus>2.17 and C) 10.68<plus-minus>2.43 mm Hg (A vs c:p<0.01, A vs B:p<0.05, a
Mean pulmonary arterial pressure and mean left atrial pressure did not show any significant difference among the three groups.
This study supports the feasibility of maintenance of hemodynamics by monoventricularization and LVAD in patients with acute MI complicating VSP and MR.
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