New Therapies to Support the Failing Heart

Introduction: Nowadays, both Extracorporeal Life Support (ECLS) and Intra-aortic balloon pump (IABP) are being widely employed to provide temporary hemodynamic support in patients suffering from a cardiogenic shock, a form of acute heart failure. Despite their increasing popularity, these techniques go hand in hand with technique related complications, whereas patient selection plays a crucial role in order to optimize patient outcome. This work is an attempt to assess the effectiveness of a new "short" Intra-Aortic Balloon Pump (IABP) cannula, relative to the conventional "long" cannula in patients with acute ischemic heart failure connected to the Extra-Corporeal Life Support (ECLS) during the treatment and withdrawal phase.

Methods: In order to assess the effectiveness of various cannulas, (IABP "short" and "long"), in a patient connected to ECLS with acute ischemic heart failure, some of the animals will be connected to the ECLS alone, and will make up the control group (n=5). One experimental group (n=5) will be connected to ECLS with the short cannula, while the third group (n=5) will be connected to ECLS with a long cannula. After placing the animals on ECLS, we will monitor hemodynamic parameters and peripheral perfusion, while artificially inducing ischemia of the heart, in both- the treatment with, and the withdrawal from ECLS.

Results: Our preliminary results show lower pulmonary artery pressure in the ECLS + balloon groups comparing with the ECLS alone group. The mesenteric blood flow seems to be higher in the ECLS + short balloon comparing to the ECLS + long balloon and the ECLS alone group. More results will be published soon.

Conclusions: According to our results, short IABP might add a positive effect to the ECLS in treating the failing heart while compromising less the blood flow to the abdominal viscera.