Experimental study of the effect for RVAD and BVAD on biventricular failure.

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  • KOGA Mamoru
    The Second Department of Surgery, School of Medicine, Nihon University

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  • 両心不全に対する右心補助人工心臓（ＲＶＡＤ）と両心補助人工心臓（ＢＶＡＤ）の効果に関する実験的検討

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It has been known that the ventricular assist device (VAD) is effective in severe ventricular failure refractory to conventional drugs and the intraaortic balloon pumping. In the future, it is expected to employ biventricular assist device (BVAD) for the patients with cardiogenic shock more frequently. Until recently, BVAD were successfully applied in a few instances unfortunately. The purpose of this experimental study is to evaluate the effect of right ventricular assist device (RVAD) and BVAD on biventricular failure with profound right ventricular failure. Biventricular failure was induced by pulmonary artery banding and ligation of left anterior descending coronary artery in 18 pigs. RVAD (10 pigs) was applied in the group I, and BVAD (8 pigs) was done in the group II. In the group I, right ventricular assistance caused increases in LAP, LVEDP and decreases in AoP, LVmax dp/dt with deterioration of left ventricular failure when the pump flow ratio (RVAD flow/total flow) exceeded 50%. On the contrary, in the group II, LAP and PAP decreased and left ventricular failure improved with biventricular assistance. Consequently BVAD could maintain the systemic circulation. The flow volume of LVAD unchanged in increasing in the flow volume of RVAD. This phenomenon seemed related to the effect of pulmonary circulation. These results suggested that in the case of biventricular failure, concomitant support of LVAD and RVAD was extremely effective for the prevention of latent left ventricular failure induced by right ventricular assistance.

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