Rei Ukita, Yatrik J. Patel, W. Kelly Wu, Sean A. Francois, Michael Cortelli Jr, Carl A. Johnson Jr, Nancy Cardwell, Jennifer R. Talackine, John W. Stokes, William Grogan, Meredith Mentz, Kaitlyn M. Tracy, Timothy R. Harris, William Tucker, Elizabeth Simonds, Caitlin T. Demarest, Keith E. Cook, David J. Skoog, Erika B. Rosenzweig, Matthew Bacchetta
Vanderbilt University Medical Center and School of Medicine. Carnegie Mellon University. Advanced Respiratory Technologies Inc. Columbia University Medical Center.
United States
Journal of Heart and Lung Transplantation
J Heart Lung Transplant 2023;
DOI: 10.1016/j.healun.2023.10.017
Abstract
Objective: Right heart failure is the major cause of death in pulmonary hypertension. Lung transplantation is the only long-term treatment option for patients who fail medical therapy. Due to the scarcity of donor lungs, there is a critical need to develop durable mechanical support for the failing right heart. A major design goal for durable support is to reduce the size and complexity of devices to facilitate ambulation. Toward this end, we sought to deploy wearable mechanical support technology in a sheep disease model of chronic right heart failure.
Methods: In six sheep with chronic right heart failure, a mechanical support system consisting of an extracorporeal blood pump coupled with a gas exchange unit was attached in a right atrium-to-left atrium configuration for up to seven days. Circuit performance, hematological parameters, and animal hemodynamics were analyzed.
Results: Six subjects underwent the chronic disease model for 56-71 days. Three of the subjects survived to the seven-day endpoint for circulatory support. The circuit provided 2.8 (0.5) L/min of flow compared to the native pulmonary blood flow of 3.5 (1.1) L/min. The animals maintained physiologically balanced blood gas profile with a sweep flow of 1.2 (1.0) L/min. Two animals freely ambulated while wearing the circuit.
Conclusions: Our novel mechanical support system provided physiologic support for a large animal model of pulmonary hypertension with right heart failure. The small footprint of the circuit and the low sweep requirement demonstrate the feasibility of this technology to enable mobile ambulatory applications.
Category
Right Heart Dysfunction Associated with Pulmonary Vascular Disease
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Animal Models of Pulmonary Vascular Disease and Therapy
Age Focus: No Age-Related Focus
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No