Key result
Peripheral ECMO support with pulmonary artery anastomosis to the caval axis provided acceptable hemodynamic stability for 6 hours in an experimental calf model of acardia.
Why the study?
Heart preservation may not be possible in extreme situations such as hyperacute rejection of heart transplant or major heart trauma, necessitating alternative support strategies.
Does peripheral ECMO support provide hemodynamic stability in an acardia calf model?
Does peripheral ECMO support provide hemodynamic stability in an acardia calf model?
Peripheral ECMO support with pulmonary artery anastomosis to the caval axis can provide short-term hemodynamic stability in an acardia model, potentially serving as a bridge to transplantation in extreme scenarios.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating in acardia calf model; should not yet influence clinical practice.
In extreme situations, such as hyperacute rejection of heart transplant or major heart trauma, heart preservation may not be possible. Our experimental team works on a project of peripheral extracorporeal membrane oxygenation (ECMO) support in acardia as a bridge to heart transplantation or artificial heart implantation. An ECMO support was established in five calves (58.6 ± 6.9 kg) by the transjugular insertion to the caval axis of a self-expanded cannula, with carotid artery return. After baseline measurements, ventricular fibrillation was induced, great arteries were clamped, heart was excised, and right and left atria remnants, containing pulmonary veins, were sutured together leaving an atrial septal defect over the caval axis cannula. Measurements of pump flow and arterial pressure were taken with the pulmonary artery clamped and anastomosed with the caval axis for a total of 6 hours. Pulmonary artery anastomosis to the caval axis provided an acceptable 6 hour hemodynamic stability, permitting a peripheral access ECMO support in extreme scenarios indicating a heart explantation.
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Marinakis et al. (2014) studied Acardia (n=5). Peripheral extracorporeal membrane oxygenation (ECMO) was evaluated on Hemodynamic stability. Peripheral ECMO support with pulmonary artery anastomosis to the caval axis provided acceptable hemodynamic stability for 6 hours in an experimental calf model of acardia.
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