INVESTIGADORES
RISK Marcelo Raul
artículos
Título:
Dynamic abdominal and thoracic aortomyoplasty in heart failure: assessment of counterpulsation
Autor/es:
EDMUNDO I. CABRERA FISCHER; ALEJANDRA CHRISTEN; EDUARDO DE FORTEZA; MARCELO RISK
Revista:
ANNALS OF THORACIC SURGERY
Editorial:
ELSEVIER SCIENCE INC
Referencias:
Año: 1999 vol. 67 p. 1022 - 1029
ISSN:
0003-4975
Resumen:
Background. Aortic counterpulsation, either biologic or
mechanical, is a useful technique to support circulation
during left ventricular dysfunction.
Methods. In this study we used an induced cardiac
failure model in acute open chest sheep to compare
hemodynamic improvements between thoracic and abdominal
aortic counterpulsation. This was achieved with
left latissimus dorsi and left hemidiaphragm muscle
flaps.
Results. Thoracic and abdominal aortic counterpulsation
in heart failure resulted in a significant improvement
of hemodynamic parameters. Subendocardial viability
index, defined as diastolic pressure-time index to
systolic tension-time index, in thoracic and abdominal
aortomyoplasty showed significant improvement (p <
0.05) when cardiac assistance was performed by electrical
stimulation of each muscle flap. A new counterpulsation
index derived from diastolic and systolic areas beneath
the aortic pressure curve was tested, obtaining a correlation
coefficient with the subendocardial viability index of
0.758 (p < 0.001). Values of subendocardial viability
index and counterpulsation index showed minimal
variability.
Conclusions. Treatment of experimentally induced cardiac
failure with dynamic abdominal aortic counterpulsation
allows an effective hemodynamic improvement in
open chest sheep. Furthermore, this diastolic arterial
pressure augmentation could be evaluated through a new
counterpulsation index derived from diastolic and systolic
areas beneath the aortic pressure curve.