Acute and chronic consequences of non-pulsatile blood flow pattern in long-term total artificial heart experiment

Jaromír Vašků, Jiří Wotke, Petr Dobšák, Atsushi Baba, Aleš Rejthar, Šárka Kuchtíčková, Kou Imachi, Yusuke Abe, Itsuro Saito, Takashi Isoyama, Shin ichi Nitta, Tomoyuki Yambe

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

Vessel pulsation is presumably a key physiological function for the optimal supply of peripheral tissues and vital organs by oxygen and nutrients. The absence of pulsatility might impair the peripheral perfusion stability and trigger microvascular dysfunction of vital organs. The main purpose of this study was to investigate the influence of non-pulsatile flow on the microcirculation in experimental goat with implanted undulation pump total artificial heart (UPTAH). A microscopic system (Keyence, Japan) for the direct observation of the microcirculation of bulbar conjunctiva was used. Following the acute flow pattern change (from pulsatile to non-pulsatile one), the number of perfused capillaries decreased significantly (from 34.7 ± 6.3 to 19.7 ± 4.1 number of capillaries/mm; P < 0.05). The velocity of erythrocytes dropped (from 526 ± 83 to 132 ± 41 μm/s; P < 0.05). The velocity of erythrocytes and capillary density were only partly recovered, when the pulsatile flow mode was restored. Histopathological analysis after 33 days of pumping in non-pulsatile mode revealed the presence of chronic venostasis, tissue edema, hemorrhages, hypoxia and ischemic necroses in the tissue samples from liver, kidneys and lung. These findings could be regarded as a direct effect of the chronic non-pulsatile pumping mode and inadequate blood supply. We conclude that the presence of pulsatile flow should be considered as a vital condition for a successful long-term survival after total artificial heart implantation.

Original languageEnglish
Pages (from-to)87-95
Number of pages9
JournalPathophysiology
Volume14
Issue number2
DOIs
Publication statusPublished - 2007 Oct

Keywords

  • Artificial heart
  • Bulbar conjunctiva
  • Microcirculation
  • Perfusion
  • Pulsatility

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Physiology (medical)

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