TY - JOUR
T1 - Superior mesenteric flow pattern during counterpulsation
T2 - is simply a shorter balloon the solution for visceral hypoperfusion?
AU - de Jong, Monique M. J.
AU - Parise, Orlando
AU - Matteucci, Francesco
AU - Tetta, Cecilia
AU - Maessen, Jos G.
AU - Gelsomino, Sandro
PY - 2020/1
Y1 - 2020/1
N2 - OBJECTIVES: We studied the flow pattern in the superior mesenteric artery (SMA) during intra-aortic balloon pump support, comparing 2 intra-aortic balloons of 2 different lengths.METHODS: Sixteen Landrace pigs (mean weight 84.0 kg +/- 6.0) were used in this study. The animals were randomly assigned to 2 groups: group 1 received an 8-Fr, 40-ml standard balloon; group 2 received an 8-Fr, 40-ml short balloon. SMA flow was measured during early, mid- and telediastole.RESULTS: The standard balloon led to a reduction in SMA flow in early diastole (P <0.001), a negative flow in mid-diastole (P <0.001) and a reincrease in telediastole (P <0.001). In contrast, in early diastole a significant reduction was observed with the short balloon (P <0.001), followed by another drop in mid-diastole (P <0.001), without reaching negative values and by a telediastolic increase (P <0.001). SMA flows were comparable between balloons during early diastole (P = 0.66), whereas they were higher with the short balloon during mid (P <0.001) and telediastole (P = 0.02). Overall, the diastolic area was significantly larger when the short balloon was used (P <0.001). Finally, during counterpulsation, mesenteric resistances increased significantly (P <0.001), although, with the short balloon, they were lower than with the standard balloon (P = 0.01).CONCLUSIONS: Despite better overall mean mesenteric diastolic flow, the short balloon leads to early- and mid-diastolic flow reduction, although to a lesser extent than the standard intra-aortic balloon pump balloon. Our data are a call for improvement in the design of the short balloon.
AB - OBJECTIVES: We studied the flow pattern in the superior mesenteric artery (SMA) during intra-aortic balloon pump support, comparing 2 intra-aortic balloons of 2 different lengths.METHODS: Sixteen Landrace pigs (mean weight 84.0 kg +/- 6.0) were used in this study. The animals were randomly assigned to 2 groups: group 1 received an 8-Fr, 40-ml standard balloon; group 2 received an 8-Fr, 40-ml short balloon. SMA flow was measured during early, mid- and telediastole.RESULTS: The standard balloon led to a reduction in SMA flow in early diastole (P <0.001), a negative flow in mid-diastole (P <0.001) and a reincrease in telediastole (P <0.001). In contrast, in early diastole a significant reduction was observed with the short balloon (P <0.001), followed by another drop in mid-diastole (P <0.001), without reaching negative values and by a telediastolic increase (P <0.001). SMA flows were comparable between balloons during early diastole (P = 0.66), whereas they were higher with the short balloon during mid (P <0.001) and telediastole (P = 0.02). Overall, the diastolic area was significantly larger when the short balloon was used (P <0.001). Finally, during counterpulsation, mesenteric resistances increased significantly (P <0.001), although, with the short balloon, they were lower than with the standard balloon (P = 0.01).CONCLUSIONS: Despite better overall mean mesenteric diastolic flow, the short balloon leads to early- and mid-diastolic flow reduction, although to a lesser extent than the standard intra-aortic balloon pump balloon. Our data are a call for improvement in the design of the short balloon.
KW - Intra-aortic balloon pump
KW - Visceral artery
KW - Visceral ischaemia
KW - PUMP
U2 - 10.1093/icvts/ivz230
DO - 10.1093/icvts/ivz230
M3 - Article
C2 - 31578569
SN - 1569-9293
VL - 30
SP - 121
EP - 128
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
IS - 1
ER -