Biomedical subjects

D Mihaylov

Publications and source records attributed to D Mihaylov.

12 recordsLinked to original sources

PubMed2000

Development of an animal model of selective coronary atherosclerosis.

BACKGROUND: Atherosclerosis causes over 40% of all deaths in the USA and Western Europe. Although several hypotheses have been proposed, the etiology and pathogenesis of the atherosclerosis remain unknown. OBJECTIVE: To develop a model of selective coronary atherosclerosis in pigs. DESIGN: An animal model of selective coronary atherosclerosis was developed by combining a guide-wire-induced endothelial injury and cholesterol-enriched diet. METHODS: Twelve pigs were subjected to guide-wire-induced injury to endothelium of left anterior descending (LAD) coronary artery. Six animals (control group) were fed a standard pig food; the remaining six animals (cholesterol group) were fed a 6%-cholesterol-enriched diet. Three animals from the control group were killed immediately after the endothelial injury (acute control group). The other three animals in the control group (chronic control group) and all animals in the cholesterol-fed group were killed 4 weeks after the injury. RESULTS: The endothelial surface and the media of the left circumflex coronary artery LCX in all animals were intact. Long eccentric areas of endothelial injury were found in the LAD coronary arteries of animals in the acute control group. Numerous fibrous atherosclerotic plaques in LAD coronary arteries were found in animals in the chronic control group as well as in animals in the cholesterol-fed group, but were highly pronounced in animals in the last group. No accumulation of lipids was found in the plaques of animals in both groups. CONCLUSIONS: Administration of a 6%-cholesterol diet for 6 weeks is not sufficient to cause coronary atherosclerosis in pigs. Selective coronary atherosclerosis can be induced within 4 weeks with the same diet when the blood vessel has been injured with a guide wire.

Animals↗

PubMed2000

Development of acute ischemic heart failure in sheep.

The goal of the present study was to develop a large animal model of acute ischemic left ventricular heart failure (LVHF) that can be used to assess the influence of the PUCA pump on the heart and circulatory system under realistic conditions. We tested the hypothesis that mild stenosis of the coronary artery in combination with mild ventricular pacing induces an acute heart failure condition, whereas the separate phenomena themselves do not lead to impaired heart function. Mean aortic pressure (AoP), left ventricular end-diastolic pressure (LVEDP), stroke volume (SV) and myocardial systolic shortening (MSS) were compared 30 minutes after a pacemaker (PM) induced tachycardia in anaesthetized sheep (n=3) without and with +/- 50% stenosis of the proximal LCx. All parameters measured restored to basic levels when stenosis was absent. When the LCx was partially occluded, mild PM-induced tachycardia resulted in decreased AoP (P=0.045) as well as in decreased SV (P=0.048); the LVEDP remained high (P=0.002). Also the recovery of MSS was impaired when stenosis was present (P=0. 002). These values indicate that acute heart failure conditions were present. The technique used proved to be safe and allowed fine-tuning of the demand ischemia by adapting heart frequency to the required heart failure conditions. The model can be used to study the effect of LV mechanical support during acute heart failure conditions.

Acute Disease↗

PubMed2000

In vivo and in vitro experience with the PUCA-II, a single-valved pulsatile catheter-pump.

The Pulsatile Catheter (PUCA) pump is a trans-arterial pulsatile ventricular assist device that can be used for short-term left ventricular support. The separate inflow and outflow valves in the first version of the device (PUCA-I) were replaced by a single inflow/outflow valve in the latest PUCA pump version (PUCA-II). The new combined valve was tested during in vitro (mock circulation) and in vivo experiments for valve leakage, flow resistance, and thrombus formation. During the in vitro experiments a maximum valve leakage of 6% during ejection and 21% during aspiration was found. The maximum flow resistance coefficient (K) was 4. The animal experiments demonstrated that the PUCA-II could be positioned within a few minutes into the left ventricle without X-ray guidance and without using a vascular graft. Thrombi were not found in the combined valve after total pump time of 3 hours, which proved the good washout of the valve. Initial experiments to position the pump in the right ventricle through the pulmonary artery were successful and contributed to the development of a new application for the device.

Animals↗

PubMed2000

Numerical simulation of the influence of a left ventricular assist device on the cardiovascular system.

The PUCA (pulsatile catheter) pump is a left ventricular assist device (LVAD) capable of unloading the left ventricle (LV) and improving coronary flow by providing a counterpulsation effect. It consists of an extracorporeal located membrane pump, coupled to a transarterial catheter that enters the body via a superficial artery and ends in the LV. Blood is aspirated from the LV and pumped in the ascending aorta through the same catheter guided by a valve system. Timing and frequency of the PUCA pump influence its efficacy. To study the influence of several pump parameters a numerical model of the device and the circulatory system has been developed. Results of animal experiments were used to validate the model. Optimization studies resulted in a pump configuration with a stroke volume of 50 cc and pump:heart frequency mode of 1:2 that starts ejection at the beginning of diastole.

Animals↗

PubMed2000

Mechanical circulatory support systems--a review.

Congestive Heart Failure (CHF) is a major health problem with a high mortality rate. Its ultimate therapy, heart transplantation, is limited by the shortage of donor hearts. Since decades researchers have been working to solve this problem by developing Mechanical Circulatory Support Systems (MCSS) that can replace or assist the failing heart. Short-term and intermediate-term ventricular assist devices are used nowadays frequently to bridge patients with severe heart failure to recovery. Long-term ventricular assist devices (VADs) and Total Artificial Hearts (TAHs) are used increasingly as a bridge to heart transplantations or as permanent circulatory support in patients with end-stage heart failure that are contraindicated for heart transplantation. The early TAHs and VADs were mainly driven from an external pneumatic drive unit. The latest generation TAHs and long-term assist devices are electrically powered, ultracompact, totally implantable, and have small wearable drive/control consoles, allowing patients to return to their daily activities. The article categorizes and reviews the development of MCSS, highlights the medical indications and contraindications of pump implantation, advantages and disadvantages of the various systems, and results of animal and clinical studies.

Adult↗

PubMed1999

Numerical simulation of the pulsating catheter pump: A left ventricular assist device.

The pulsating catheter (PUCA) pump, a left ventricular assist device, consists of a hydraulically or pneumatically driven membrane pump, extracorporeally placed and mounted to a valved catheter. The catheter is introduced into an easily accessible artery and positioned with its distal tip in the left ventricle. Blood is aspirated from the left ventricle during systole and ejected into the ascending aorta during diastole. A numerical model of the PUCA pump has been developed to determine the internal diameter of the PUCA pump catheter that allows a certain blood flow. The model considers a limitation of mechanical blood damage and determines the accompanying pressure and flow profile for driving the pump. For a flow of 5 L/min, a catheter with an internal diameter of at least 6. 95 mm is required. For 3 L/min, the minimal diameter is 5.50 mm. The latter catheter can be introduced in the axillary artery, the former via the aorta during an open thorax surgical procedure. To validate the numerical model, 2 different PUCA pump configurations were tested in vitro. Results showed a good resemblance between model and in vitro behavior of the PUCA pump.

Aorta↗

PubMed1999

Evaluation of the optimal driving mode during left ventricular assist with pulsatile catheter pump in calves.

The pulsatile catheter (PUCA) pump, a left ventricular assist device, was tested during acute experiments in calves using asynchronous and ECG-synchronous assist modes. The aim of the study is to compare ECG-synchronous and asynchronous assist and to find the optimal driving mode for the PUCA pump with respect to left ventricular myocardial oxygen consumption (LV MVO2), pump flow, and coronary flow. LV MVO2 decreased significantly during the asynchronous (from 7.77 to 6.46 ml/min/100 g) as well as during the ECG-synchronous mode (from 8.88 to 7.84 ml/min/100 g). The pump flow was highest during the ECG-synchronous assist (2.94 L/min), followed by the asynchronous assist (2.79 L/min). The peak coronary flow depended strongly on pump ejection timing and showed the best flow patterns during the ECG-synchronous assist. We concluded that for PUCA pump support both asynchronous and ECG-synchronous assists significantly reduce LV MVO2 and that the pump flow generated is enough to maintain the systemic circulation. However, we find the ECG-synchronous mode preferable because this mode optimizes coronary flow patterns at the same time.

Animals↗

PubMed1997

Development of a numerical simulation model of the cardiovascular system.

A numerical simulation model of the cardiovascular system has been developed. It consists of a model of the left atrium, the left ventricle, the coronary vascular system, the aorta, the arterial system, and the venous system. The input of the complete model is the elastance (pressure/volume ratio) developed by the left ventricle. The shape of this elastance is constant in different circumstances. Left ventricular (LV) myocardial oxygen consumption and the amount of oxygen offered to the left ventricle can be calculated with the model. The model has been validated using data from a patient suffering from coronary artery disease. The measured clinical hemodynamical waveforms could be fitted to those generated by the model. With the numerical simulation model, it is possible to predict the functioning of the left ventricle under different circumstances. This makes it possible to study in vitro various pathological clinical situations.

Aorta↗

PubMed1997

Development of a new introduction technique for the pulsatile catheter pump.

The pulsatile catheter (PUCA) pump is an intraventricular blood pump that can be introduced into the left ventricular cavity through a superficial artery (transarterially) or directly through the thoracic aorta during open chest conditions. When positioned, the pump aspirates blood from the left ventricle and transports it into the ascending aorta. A pneumatic driving system allows the blood to be ejected in early diastole of every second or third heart beat. The main goal of this study was to develop an easy, fast, safe surgical introduction technique. Four different means of catheter introduction were tested in 20 acute open chest experiments with calves: introduction without any guidance at all, introduction by x-ray guidance only, introduction using a guide wire plus x-ray guidance, and introduction using a guiding pressure catheter. Introducing the PUCA pump catheter into the left ventricular cavity using a pigtail guiding pressure catheter proved to be easy. The large bore pump catheter followed the guiding catheter and passed the aortic valve well. The position of the PUCA pump could be monitored from the pressure patterns derived from the guiding catheter.

Animals↗

PubMed1997

Numerical modelling of blood flow behaviour in the valved catheter of the PUCA-pump, a LVAD.

Mechanical heart assistance, performed by the PUlsatile CAtheter (PUCA) pump, chronologically takes place by sucking blood from the left ventricle and ejecting it into the ascending aorta. Within the pump activity the problem of hemolysis and clotting is encountered. In this study the influence of valve geometry on blood cell damage and stagnant zones has been investigated. A variable valve length coupled to a catheter ejection gap and a variable valve angle have been studied. In case of the studied valve, optimal parameter values have been determined. Compared to small catheter ejection gaps with a corresponding valve length, blood damage is found to be less for large ejection gaps with corresponding valve dimensions. In systole a valve positioned in a 0 degree angle proves to be best, whereas in diastole a +20 degree angle is preferable. Because the system is operating in both systole and diastole, a 0 degree angle valve is applied.

Blood Coagulation↗

PubMed1996

Biological evaluation of mechanical circulatory support systems in calves.

Data from animal experiments with mechanical circulatory support systems (MCSS) performed in Groningen and Marseille over the past years were used to obtain normal values of hematological, coagulation, rheological and blood chemistry parameters in calves. These parameters were divided between two groups: a limited number of parameters necessary to assess biocompatibility properties of MCSS quickly and a more extensive number of parameters suitable for more detailed biological evaluation of blood pumps. All applied tests can be examined in calf blood as well as in human blood. Parameters were selected on clinical relevance and usefulness for standardization procedures. The obtained data were compared with normal values in human beings derived from the literature.

Animals↗

PubMedDate not supplied

A novel implantable electromechanical ventricular assist device. First acute animal testing.

A novel ventricular assist device (HIA-EMLVAD-AT1, Helmholtz Institute Aachen-Electromechanical Left Ventricular Assist Device-Animal Test Version 1), driven by a uniformly and unidirectionally rotating actuator and a patented hypocycloidic pusherplate displacement gear unit, was developed and tested in an acute animal experiment. The excellent free filling behavior of the pump chamber with a stroke volume of 65 ml is obtained by a 2:3 ejection-filling time relationship. The uniform motor rotation facilitates simple sensorless pre and afterload detection by motor current analysis. In contrast to common apical cannulation, the inlet cannula was placed via the left atrium through the mitral valve into the left ventricle. This connection mode is preferable for left ventricular recovery and preservation. Left atrial, left ventricular, and aortic pressure curves, as well as pulmonary artery flow data, were obtained. The data show very effective unloading of the natural ventricle and demonstrate the feasibility of this novel assist device. Directions for further improvement of technical features were also identified.

Animals↗