HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tozzi, P. Articles by von Segesser, L.K. Search for Related Content PubMed PubMed Citation Articles by Tozzi, P. Articles by von Segesser, L.K. Related Collections Mechanical Circulatory Assistance

Eur J Cardiothorac Surg 2004;26:726-729
© 2004 Elsevier Science NL

Muscular counterpulsation: preliminary results of a non-invasive alternative to intra-aortic balloon pump

^a Service de Chirurgie CardioVasculaire-BH10, Centre Hospitalier Universitaire Vaudois—CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland
^b CardioLa Ltd, Winterthur, Switzerland

Received 20 August 2003; received in revised form 15 February 2004; accepted 1 March 2004.

^* Corresponding author. Tel.: +21-314-22-80 fax: +21-314-22-78
e-mail: tozzig{at}hotmail.com
e-mail: piergiorgio.tozzig{at}hospvd.ch

Objectives: IABP is the most widely used form of temporary cardiac assist and its benefits are well established. We designed an animal study to evaluate a device based on muscular counterpulsation (MCP) that should reproduce the same hemodynamic effects as IABP in a completely non-invasive way. Methods: Six calves, 60±4 kg, divided into 2 groups, in general anaesthesia, equipped with EKG, Swan-Ganz, pressure probe in the femoral artery and flow probe in the left carotid artery, received either IABP through right femoral artery, or muscle counterpulsation (MCP). MCP consists of electrically induced skeletal muscle contraction during early diastole, triggered by EKG and microprocessor controlled by a portable device. For each animal the following parameters were also considered: mean aortic pressure (mAoP), CO, CI, left ventricular stroke work index (LVSWI), systemic vascular resistance (SVR) and mean femoral artery flow (Faf). We did 3 sets of measurements: baseline (BL), after 20 (M20) and 40 (M40) min of cardiac assistance. These measurements have been repeated after 40 min of rest for 3 times. Results are expressed as mean±SD. Results: Baseline values: mAoP, 76.51±12 mmHg; mCVP, 11.5±3 mmHg; CO, 5±1 l/min per m²; LVSWI, 0.77±0.2 KJ/m²; SVR, 1040±15 dyn s/cm^–5; Faf, 75.5±10 ml/min. IABP group: mAoP, 81.1±6 mmHg; mCVP, 1±0.1 mmHg; CO, 4.5±0.7 l/min per m²; LVSWI, 0.69±0.2 KJ/m²; SVR, 1424±8 dyn s/cm^–5; Faf, 64.3±3 ml/min. MCP group: mAoP, 60.1±7 mmHg; mCVP, 23.6±2 mmHg; CO, 4.8±0.4 l/min per m²; LVSWI, 0.69±0.2 KJ/m²; SVR, 608±25 dyns/cm^–5; Faf, 92.3±12 ml/min. Conclusions: MCP and IABP had the same effects on CO and LVSWI. Moreover, MCP reduced SVR and increased the peripheral circulation without requiring any vascular access nor anticoagulation therapy.

Key Words: Muscular counterpulsation • IABP • Cardiac assist • Ventricular dysfunction • Peripheral flow