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Left Ventricular Assist via Percutaneous Transhepatic Transseptal Cannulation in Swine
Journal article   Open access   Peer reviewed

Left Ventricular Assist via Percutaneous Transhepatic Transseptal Cannulation in Swine

D. Scott Lim, Cory J. Cortese, Amber N. Loree, David A. Dean, Robert G. Svitek and Christos D Katsetos
Catheterization and cardiovascular interventions, v 73(7), pp 961-965
01 Jun 2009
PMID: 19213076
url
https://doi.org/10.1002/ccd.21934View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology
Objective: To report the in vivo testing of transhepatic, transseptal cannula insertion to support the left ventricle. Background: Percutaneous cannulation for circulatory assist poses particular challenges in pediatrics. We utilized a strategy using a transhepatic, transseptal venous cannula inserted into the left atrium, a centrifugal pump, and arterial cannula. Methods: Yorkshire swine of 5-20 kg (n = 6) were anesthetized for the procedure. After hepatic venous angiography, percutaneous puncture of the hepatic vein was performed, followed by transseptal puncture with echocardiographic guidance. A 10-14 Fr 26-cm venous inflow cannula was placed in the left atrium via hepatic approach. The femoral artery was cannulated with a 6-10 Fr femoral cannula, and the circuit completed with the TandemHeart centrifugal pump. Results: Implantation of the system utilizing the transhepatic approach was successful in all experiments. The pump delivered flows ranging from 0.8 to 1.4 L/min, which corresponded to 40-86% of the baseline systemic outputs. Decannulation and occlusion of the hepatic tract was successful utilizing transcatheter vascular occlusion plugs. Conclusion: The transhepatic, transseptal insertion of the inflow cannula, coupled with the TandemHeart centrifugal pump and femoral arterial cannulation allows percutaneous circulatory support in 5- to 20-kg models. (C) 2009 Wiley-Liss, Inc.

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Cardiac & Cardiovascular Systems
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