ABSTRACT
The internal ventricular venting loop (IVVL) catheter is a coaxial, two lumen, bidirectional flow cannula introduced peripherally and advanced intraluminally to the pulmonary artery by its flow directed, balloon tipped inner tubing in a right ventricular assist system (RVAS), or to the left ventricle over a guide wire under fluoroscopy in a left ventricular assist system (LVAS). Its use was successfully tested in six acute canine experiments using a small IVVL catheter. Hemodynamic responses to increasing roller pump flow rates, to a maximum of 1 L/min, were initially measured. Then, hemodynamic changes to 600 ml/min, after left anterior descending artery ligation (in IVVL-LVAS) and 300 ml/min after right coronary artery ligation (in IVVL-RVAS) were regularly recorded every 15 min until cardiac arrest. The IVVL-LVAS was able to significantly decrease the pulmonary capillary wedge pressure, while the IVVL-RVAS was able to significantly decrease the central venous pressure. The IVVL system was able to partially unload the ventricles and restore about 33-60% of the cardiac output. However, it could not effectively support the heart during arrest. Thus, the IVVL catheter can facilitate simple and effective single cannulation for either RVAS or LVAS. This approach may enable ordinary cardiac centers to make use of already available blood pumps for temporary, inexpensive, and less invasive application of partially assisted circulation when intra aortic balloon pump assistance fails.
