BACKGROUND: Acute heart failure refractory to medical therapy is a major cause of morbidity and mortality. The Aortix device (Procyrion Inc) is a percutaneously delivered entrainment pump positioned in the descending aorta. METHODS AND RESULTS: Using the newest generation Aortix device in 8 adult male Yorkshire swine, we tested the hypothesis that positioning in the abdominal aorta may provide superior hemodynamic effects than thoracic positioning in a swine model of postinfarct left ventricular injury.Abdominal activation generated significantly larger transaortic gradients (proximal minus distal mean aortic pressures) than thoracic positioning at all pump speeds. Compared with baseline values, activation in the abdominal, not thoracic, position significantly increased cardiac output, reduced arterial elastance, and systemic vascular resistance at low speeds. Compared with baseline values, abdominal activation also increased transpulmonary pressure gradients at medium and high speed, which was driven by trends toward higher mean pulmonary artery pressure and lower pulmonary capillary wedge pressure. CONCLUSIONS: This is the first report to determine that in contrast to thoracic positioning, abdominal positioning of the newest generation Aortix device reduces left ventricular afterload and increases cardiac output at low speeds. These findings have potentially important implications for the design of early clinical studies by suggesting that device position and speed are major determinants of improved hemodynamic efficacy.
BACKGROUND: Acute heart failure refractory to medical therapy is a major cause of morbidity and mortality. The Aortix device (Procyrion Inc) is a percutaneously delivered entrainment pump positioned in the descending aorta. METHODS AND RESULTS: Using the newest generation Aortix device in 8 adult male Yorkshire swine, we tested the hypothesis that positioning in the abdominal aorta may provide superior hemodynamic effects than thoracic positioning in a swine model of postinfarct left ventricular injury.Abdominal activation generated significantly larger transaortic gradients (proximal minus distal mean aortic pressures) than thoracic positioning at all pump speeds. Compared with baseline values, activation in the abdominal, not thoracic, position significantly increased cardiac output, reduced arterial elastance, and systemic vascular resistance at low speeds. Compared with baseline values, abdominal activation also increased transpulmonary pressure gradients at medium and high speed, which was driven by trends toward higher mean pulmonary artery pressure and lower pulmonary capillary wedge pressure. CONCLUSIONS: This is the first report to determine that in contrast to thoracic positioning, abdominal positioning of the newest generation Aortix device reduces left ventricular afterload and increases cardiac output at low speeds. These findings have potentially important implications for the design of early clinical studies by suggesting that device position and speed are major determinants of improved hemodynamic efficacy.
Authors: Clyde W Yancy; Mariell Jessup; Biykem Bozkurt; Javed Butler; Donald E Casey; Mark H Drazner; Gregg C Fonarow; Stephen A Geraci; Tamara Horwich; James L Januzzi; Maryl R Johnson; Edward K Kasper; Wayne C Levy; Frederick A Masoudi; Patrick E McBride; John J V McMurray; Judith E Mitchell; Pamela N Peterson; Barbara Riegel; Flora Sam; Lynne W Stevenson; W H Wilson Tang; Emily J Tsai; Bruce L Wilkoff Journal: Circulation Date: 2013-06-05 Impact factor: 29.690
Authors: Kevin J Morine; Xiaoying Qiao; Vikram Paruchuri; Mark J Aronovitz; Emily E Mackey; Lyanne Buiten; Jonathan Levine; Keshan Ughreja; Prerna Nepali; Robert M Blanton; Richard H Karas; S Paul Oh; Navin K Kapur Journal: Heart Vessels Date: 2017-02-17 Impact factor: 2.037
Authors: Shiva K Annamalai; Lyanne Buiten; Michele L Esposito; Vikram Paruchuri; Andrew Mullin; Catalina Breton; Robert Pedicini; Ryan O'Kelly; Kevin Morine; Benjamin Wessler; Ayan R Patel; Michael S Kiernan; Richard H Karas; Navin K Kapur Journal: J Card Fail Date: 2017-05-26 Impact factor: 5.712
Authors: J Baan; E T van der Velde; H G de Bruin; G J Smeenk; J Koops; A D van Dijk; D Temmerman; J Senden; B Buis Journal: Circulation Date: 1984-11 Impact factor: 29.690
Authors: Navin K Kapur; Vikram Paruchuri; Jose Angel Urbano-Morales; Emily E Mackey; Gerard H Daly; Xiaoying Qiao; Natesa Pandian; George Perides; Richard H Karas Journal: Circulation Date: 2013-06-13 Impact factor: 29.690
Authors: Navin K Kapur; Richard H Karas; Sarah Newman; Lena Jorde; Tina Chabrashvili; Shiva Annamalai; Michele Esposito; Carey D Kimmelstiel; Tim Lenihan; Daniel Burkhoff Journal: Catheter Cardiovasc Interv Date: 2019-05-21 Impact factor: 2.692