Key result
Left atrial assist device maintains sufficient hemodynamics at mitral and supravalvular levels in vitro.
Why the study?
A left atrial assist device is being developed for HFpEF, but the hemodynamic effects of implanting it at the mitral valve level versus the supravalvular level with preserved mitral valve function required assessment.
Does a left atrial assist device implanted at the supravalvular level maintain hemodynamic status compared to implantation at the mitral valve level in an in vitro model of HFpEF?
Does a left atrial assist device implanted at the supravalvular level maintain hemodynamic status compared to implantation at the mitral valve level in an in vitro model of HFpEF?
An in vitro mock circulatory loop study suggests a novel left atrial assist device can effectively restore hemodynamics in simulated HFpEF regardless of whether the native mitral valve is preserved or removed.
LAAD supravalvular placement maintains hemodynamics in vitro; leaves open translation to in vivo HFpEF models.
We are developing a left atrial assist device (LAAD) to pump blood from the left atrium to the left ventricle for patients who have heart failure with preserved ejection fraction (HFpEF). This study aimed to assess the hemodynamics with the LAAD implanted at two different levels: the mitral valve (MV) level, after removing the MV; and the supravalvular level, preserving MV function conditions using an in vitro mock circulatory loop. Normal heart and mild, moderate, and severe diastolic heart failure conditions were simulated, and the LAAD was set at three different speeds. Without the LAAD support, cardiac output (CO) decreased from 3.7 to 1.1 L/min, aortic pressure (AoP) decreased from 100 to 33 mm Hg, and left atrial pressure (LAP) increased from 16 to 23 mm Hg as the diastolic function became impaired. With high pump support after removing the MV, CO and AoP readings were comparable with those for preserved MV function (CO reached 3.9-4.1 L/min, AoP reached more than 110 mm Hg, and LAP dropped to 16-17 mm Hg under both conditions at high pump speeds). In the mock circulatory loop, our LAAD appeared to have sufficient ability to maintain the hemodynamic status at both positions.
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Kado et al. (2020) studied Heart failure with preserved ejection fraction (HFpEF). Left atrial assist device (LAAD) vs. Without LAAD support / between two implantation levels was evaluated on Hemodynamics (cardiac output, aortic pressure, left atrial pressure). A left atrial assist device maintained sufficient hemodynamic status (CO 3.9-4.1 L/min, AoP >110 mm Hg, LAP 16-17 mm Hg) at both the mitral valve and supravalvular levels in an in vitro mock loop.
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