Asian Annals
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Juan C Chachques
Alain Carpentier
Right arrow Permission Requests
Google Scholar
Right arrow Articles by Nour, S.
Right arrow Articles by Payen, D.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Nour, S.
Right arrow Articles by Payen, D.

REVIEW PAPER

The Forgotten Driving Forces in Right Heart Failure: New Concept and Device*

Sayed Nour1, Guifu Wu2, Zheng Zhensheng2, Juan C Chachques1, Alain Carpentier1, Didier Payen3

1 Laboratory of Biosurgical Research, Pompidou Hospital, University of Paris, France
2 Cardiovascular Research Center, The First Affiliated Hospital Sun Yat-sen University, Guangzhou, China
3 Department of Anesthesiology, Critical Care and SAMU, Lariboisiere Hospital, Paris, France

Sayed Nour, Tel: +0033140907615, Fax: +0033145405049, E-mail: nourmd{at}mac.com, Laboratory of Biosurgical Research, 96 rue Didot, 75014 Paris, France.

Background: Right heart failure is a frequent hemodynamic disturbance in pediatric cardiac patients. Besides inotropic and chronotropic drugs, fluid administration and inhaled nitric oxide, right ventricular mechanical assistance remains difficult to perform. A circulatory assist device adapted for the right heart biophysics and physiology might be more efficient. Materials and Methods: We are developing a prototype of a non-invasive cardiac assist device (CAD) for neonates and pediatrics. It is based on a pulsatile suit device covering and affecting all territories of the right heart circuit. It will be tested in a neonatal animal model of right ventricular (RV) failure. Experimental models will be matched and compared with control and sham groups. Expected results would be immediate hemodynamic improvement due to synchronized diastolic reduction of stagnant venous capacitance, increasing preload and contractility. On long term, increased shear stress with changing intrathoracic pressure in a phasic way would improve and remodel the pulmonary circulation. Future studies will be focused on: hemodynamic, biochemistry, endothelium function test, and angiogenesis. Comments: A non-invasive CAD guarantees better hemodynamics and endothelial function preservation with low morbidity and mortality. This is a physiological approach, cost-effective method, and particularly interesting in neonates and pediatrics with RV failure.

Key Words: Pulsatile suit • Right heart failure • Shear stress • Pediatric circulatory assist device

Asian Cardiovasc Thorac Ann 2009; 17:525-530
© 2009 by SAGE Publications
DOI: 10.1177/0218492309348638




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by SAGE Publications