SciELO - Scientific Electronic Library Online

 
vol.27 número4Efeito do exercício associado ao transplante de células-tronco sobre a função ventricular de ratos pós-infarto agudo do miocárdioEvolução clínica e capacidade funcional de pacientes com cardiomiopatia dilatada após quatro anos do transplante índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

Compartilhar


Brazilian Journal of Cardiovascular Surgery

versão impressa ISSN 0102-7638

Resumo

SANTOS, Luis Alberto Saraiva et al. Cavo-pulmonary anastomosis associated with left ventricular in comparison with biventricular circulatory support in acute heart failure. Rev Bras Cir Cardiovasc [online]. 2012, vol.27, n.4, pp.552-561. ISSN 0102-7638.  https://doi.org/10.5935/1678-9741.20120097.

OBJECTIVE: Right ventricular (RV) failure during left ventricular assist device (LVAD) support can result in severe hemodynamic compromise with high mortality. This study investigated the acute effects of cavo-pulmonary anastomosis on LVAD performance and RV myocardial compromise in comparison with biventricular circulatory support, in a model of biventricular failure. METHODS: LVAD support was performed by centrifugal pump in 21 pigs with severe biventricular failure obtained by FV induction. Animals were randomized to be submitted to cavo-pulmonary anastomosis, to biventricular circulatory support or to control group. They were maintained under circulatory support and hemodynamic monitoring for 3h. Venous lactate and cytokines serum levels were also obtained. Endocardium samples were analyzed by electronic microscopy. RESULTS: FV maintenance was responsible for acute LVAD impairment after 180 min in the control group. cavo-pulmonary anastomosis resulted in non-significant improvement of LVAD pump flow in relation to control group (+55±14 ml/kg/min, P=0.072), while animals under biventricular support maintained higher LVAD flow (+93±17 ml/kg/min, P=0.012). Mean arterial pressure remained constant only in biventricular group (P<0.001), which also presented decrease of right atrial and ventricular pressures. Similar increases in lactate and cytokines levels were observed in the three groups. Ultra-structural analysis documented low levels of myocardial swelling in the biventricular group (P=0.017). CONCLUSION: The concomitant use of cavo-pulmonary anastomosis during LVAD support in a pig model of severe biventricular failure resulted in non-significant improvement of hemodynamic performance and it did not effectively replace the use of biventricular support.

Palavras-chave : Heart-assist devices; Heart failure; Ventricular dysfunction, right; Heart bypass, right; Swine.

        · resumo em Português     · texto em Português     · Português ( pdf ) | Inglês ( pdf )

 

Creative Commons License Todo o conteúdo deste periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons